| NPI | 1386800985 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0127X Surgery, Trauma Surgery (Licence: WI 66005) |
| Additional Taxonomies | 208600000X Surgery (Licence: IL 125053411) |
| 208600000X Surgery (Licence: IL 036.123951) | |
| 208600000X Surgery (Licence: WI 66005) | |
| Enumeration Date | 2008-08-03 |
| Last Update Date | 2016-10-28 |