| NPI | 1174519888 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0127X Surgery, Trauma Surgery (Licence: NC 2012-01790) |
| Additional Taxonomies | 2086S0127X Surgery, Trauma Surgery (Licence: OH 35-052836) |
| Enumeration Date | 2005-09-27 |
| Last Update Date | 2013-02-04 |