| NPI | 1215147707 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0127X Surgery, Trauma Surgery (Licence: TX N4849) |
| Additional Taxonomies | 208600000X Surgery (Licence: TX N4849) |
| 208600000X Surgery (Licence: OH 58-001323) | |
| Enumeration Date | 2007-05-23 |
| Last Update Date | 2022-09-19 |