| NPI | 1508044538 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0127X Surgery, Trauma Surgery (Licence: OH PENDING) |
| Additional Taxonomies | 208600000X Surgery (Licence: OH PENDING) |
| Enumeration Date | 2008-02-01 |
| Last Update Date | 2022-01-05 |