| NPI | 1255573812 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0127X Surgery, Trauma Surgery (Licence: MS 24484) |
| Additional Taxonomies | 208600000X Surgery (Licence: PA MD454907) |
| Enumeration Date | 2009-03-28 |
| Last Update Date | 2017-04-28 |