| NPI | 1356418479 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0127X Surgery, Trauma Surgery (Licence: MO 2005021461) |
| Additional Taxonomies | 208600000X Surgery (Licence: MO 2005021461) |
| Enumeration Date | 2006-11-30 |
| Last Update Date | 2013-02-19 |