| NPI | 1194854091 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0127X Surgery, Trauma Surgery (Licence: GA 77728) |
| Additional Taxonomies | 2086S0127X Surgery, Trauma Surgery (Licence: VA 0101244576) |
| Enumeration Date | 2007-03-05 |
| Last Update Date | 2017-05-05 |