| NPI | 1518937085 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0127X Surgery, Trauma Surgery (Licence: WI 52043-20) |
| Additional Taxonomies | 208600000X Surgery (Licence: CA A64368) |
| Enumeration Date | 2006-01-25 |
| Last Update Date | 2020-01-23 |