| NPI | 1154490506 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: MI 5101024436) |
| Additional Taxonomies | 2086S0127X Surgery, Trauma Surgery (Licence: MD H74025) |
| 208600000X Surgery (Licence: CA 20A11240) | |
| 2086S0127X Surgery, Trauma Surgery (Licence: PA OS016805) | |
| Enumeration Date | 2006-11-07 |
| Last Update Date | 2022-07-29 |