| NPI | 1295759850 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0127X Surgery, Trauma Surgery (Licence: LA 05539R) |
| Additional Taxonomies | 208600000X Surgery (Licence: TX G1230) |
| 208600000X Surgery (Licence: CA G28185) | |
| 208600000X Surgery (Licence: NC 25673) | |
| 208600000X Surgery (Licence: MS 9525) | |
| 208600000X Surgery (Licence: SC 15769) | |
| 208600000X Surgery (Licence: MN 33847) | |
| 208600000X Surgery (Licence: NM 98-198) | |
| 208600000X Surgery (Licence: WA 025209) | |
| 208600000X Surgery (Licence: ID M7531) | |
| 2086S0127X Surgery, Trauma Surgery (Licence: WI 50898) | |
| Enumeration Date | 2006-07-27 |
| Last Update Date | 2012-07-30 |