| NPI | 1215160379 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0127X Surgery, Trauma Surgery (Licence: AZ 50084) |
| Additional Taxonomies | 208600000X Surgery (Licence: AZ R71393) |
| Enumeration Date | 2009-08-24 |
| Last Update Date | 2019-07-16 |