| NPI | 1215248604 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0127X Surgery, Trauma Surgery (Licence: FL ME148845) |
| Additional Taxonomies | 2086S0127X Surgery, Trauma Surgery (Licence: IL 036.137090) |
| Enumeration Date | 2010-06-30 |
| Last Update Date | 2022-01-07 |