| NPI | 1396956686 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: OH 57012024) |
| Additional Taxonomies | 2086S0127X Surgery, Trauma Surgery (Licence: CO DR.0055624) |
| Enumeration Date | 2007-05-25 |
| Last Update Date | 2021-03-10 |