| NPI | 1144420951 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0127X Surgery, Trauma Surgery (Licence: CA A100789) |
| Additional Taxonomies | 208600000X Surgery (Licence: MA 247890) |
| Enumeration Date | 2007-07-19 |
| Last Update Date | 2018-07-31 |