| NPI | 1144540295 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0127X Surgery, Trauma Surgery (Licence: NE 31555) |
| Additional Taxonomies | 208600000X Surgery (Licence: PA MT196177) |
| Enumeration Date | 2010-06-10 |
| Last Update Date | 2019-05-14 |