| NPI | 1215048608 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: FL ME121941) |
| Additional Taxonomies | 208600000X Surgery (Licence: GA 048085) |
| 2086S0127X Surgery, Trauma Surgery (Licence: GA 048085) | |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2015-02-24 |