| NPI | 1487745329 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0127X Surgery, Trauma Surgery (Licence: NH 15300) |
| Additional Taxonomies | 2086S0127X Surgery, Trauma Surgery (Licence: MA 77020) |
| 208600000X Surgery (Licence: MA 77020) | |
| 208600000X Surgery (Licence: NH 15300) | |
| Enumeration Date | 2006-09-27 |
| Last Update Date | 2011-12-05 |