| NPI | 1639166739 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: FL ME89364) |
| Additional Taxonomies | 2086S0127X Surgery, Trauma Surgery (Licence: FL ME89364) |
| Enumeration Date | 2005-10-04 |
| Last Update Date | 2016-03-04 |