| 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 |