| NPI | 1558320085 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: MA 154933) |
| Additional Taxonomies | 208600000X Surgery (Licence: CT 043880) |
| 2086S0127X Surgery, Trauma Surgery (Licence: CT 043880) | |
| 2086S0127X Surgery, Trauma Surgery (Licence: NY 267445) | |
| Enumeration Date | 2006-03-22 |
| Last Update Date | 2020-02-14 |