| NPI | 1154670487 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: TX Q1472) |
| Additional Taxonomies | 2086S0127X Surgery Trauma Surgery (Licence: TX Q1472) |
| Enumeration Date | 2012-08-31 |
| Last Update Date | 2014-11-10 |