| NPI | 1659356434 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: OH 35042853) |
| Additional Taxonomies | 2086S0127X Surgery, Trauma Surgery (Licence: PA MD037893E) |
| Enumeration Date | 2005-12-14 |
| Last Update Date | 2014-11-19 |