| NPI | 1255532990 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0127X Surgery, Trauma Surgery (Licence: CO DR.0067841) |
| Additional Taxonomies | 2086S0127X Surgery, Trauma Surgery (Licence: CA A107306) |
| 2086S0127X Surgery, Trauma Surgery (Licence: FL ME130660) | |
| Enumeration Date | 2007-05-30 |
| Last Update Date | 2022-04-05 |