| NPI | 1487675740 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0127X Surgery Trauma Surgery (Licence: AL 14648) |
| Additional Taxonomies | 2086S0127X Surgery Trauma Surgery (Licence: LA MD08201R) |
| Enumeration Date | 2006-07-22 |
| Last Update Date | 2015-05-12 |