| NPI | 1538279765 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0127X Surgery Trauma Surgery (Licence: CA G80892) |
| Additional Taxonomies | 208600000X Surgery (Licence: CA G80892) |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2020-01-15 |