| NPI | 1215107842 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0127X Surgery, Trauma Surgery (Licence: GA 061132) |
| Additional Taxonomies | 208600000X Surgery (Licence: GA 061132) |
| Enumeration Date | 2008-03-11 |
| Last Update Date | 2019-10-09 |