| NPI | 1598735490 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0127X Surgery, Trauma Surgery (Licence: OR MD13786) |
| Additional Taxonomies | 2086S0127X Surgery, Trauma Surgery (Licence: WA MD00023470) |
| Enumeration Date | 2006-01-24 |
| Last Update Date | 2007-07-08 |