| NPI | 1518991876 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0127X Surgery, Trauma Surgery (Licence: FL ME110714) |
| Additional Taxonomies | 2086S0127X Surgery, Trauma Surgery (Licence: TX MO546) |
| Enumeration Date | 2006-07-10 |
| Last Update Date | 2022-10-18 |