| NPI | 1417481367 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: FL ME150196) |
| Additional Taxonomies | 2086S0127X Surgery Trauma Surgery (Licence: FL ME150196) |
| Enumeration Date | 2017-04-18 |
| Last Update Date | 2023-11-17 |