| NPI | 1255571279 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0127X Surgery, Trauma Surgery (Licence: TN MD54788) |
| Additional Taxonomies | 208600000X Surgery (Licence: TX BP10030805) |
| 208600000X Surgery (Licence: MA 256038) | |
| 2086S0127X Surgery, Trauma Surgery (Licence: OH 35126346) | |
| Enumeration Date | 2009-03-03 |
| Last Update Date | 2022-03-30 |