NPI | 1568645703 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2086S0127X Surgery, Trauma Surgery (Licence: LA 306992) |
Additional Taxonomies | 2086S0127X Surgery, Trauma Surgery (Licence: NC 2011-01800) |
Enumeration Date | 2007-12-11 |
Last Update Date | 2018-03-17 |