| NPI | 1295990356 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0127X Surgery, Trauma Surgery (Licence: OH 35.123636) |
| Additional Taxonomies | 208600000X Surgery (Licence: PA MD455007) |
| Enumeration Date | 2008-07-28 |
| Last Update Date | 2016-10-05 |