| NPI | 1235251075 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: TX M3933) |
| Additional Taxonomies | 2086S0127X Surgery, Trauma Surgery (Licence: TX M3933) |
| Enumeration Date | 2007-04-04 |
| Last Update Date | 2013-01-21 |