| NPI | 1548528342 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: FL ME139850) |
| Additional Taxonomies | 174400000X Specialist (Licence: FL ME139850) |
| 208600000X Surgery (Licence: NV 17313) | |
| 2086S0127X Surgery Trauma Surgery (Licence: FL ME139850) | |
| Enumeration Date | 2012-04-30 |
| Last Update Date | 2022-07-22 |