| NPI | 1285632828 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0127X Surgery, Trauma Surgery (Licence: SC 35012) |
| Additional Taxonomies | 2086S0127X Surgery, Trauma Surgery (Licence: KS 0419881) |
| 2086S0127X Surgery, Trauma Surgery (Licence: PA MD441617) | |
| Enumeration Date | 2005-07-08 |
| Last Update Date | 2019-01-17 |