| NPI | 1366470288 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0127X Surgery, Trauma Surgery (Licence: PA MD437249) |
| Additional Taxonomies | 208600000X Surgery (Licence: VA 0101057816) |
| Enumeration Date | 2006-06-29 |
| Last Update Date | 2011-03-16 |