| NPI | 1245492818 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0127X Surgery, Trauma Surgery (Licence: NY 60-276050) |
| Additional Taxonomies | 208600000X Surgery (Licence: PA mt192522) |
| Enumeration Date | 2008-06-25 |
| Last Update Date | 2017-03-09 |