| NPI | 1619187408 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0127X Surgery, Trauma Surgery (Licence: MD D0077141) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MD D0077141) |
| 208600000X Surgery (Licence: MD D77141) | |
| Enumeration Date | 2007-05-23 |
| Last Update Date | 2019-05-31 |