| NPI | 1477650109 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: WI 44670) |
| Additional Taxonomies | 2086S0127X Surgery Trauma Surgery (Licence: WI 44670) |
| Enumeration Date | 2006-09-16 |
| Last Update Date | 2022-08-15 |