| NPI | 1508821067 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0127X Surgery, Trauma Surgery (Licence: TN 2911) |
| Additional Taxonomies | 208600000X Surgery (Licence: OH 34-008439) |
| 208600000X Surgery (Licence: TN 2911) | |
| 2086S0127X Surgery, Trauma Surgery (Licence: OH 35-008439) | |
| 2086S0127X Surgery, Trauma Surgery (Licence: FL OS10105) | |
| Enumeration Date | 2006-04-19 |
| Last Update Date | 2022-07-21 |