| NPI | 1679641708 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: MO 2004016404) |
| Additional Taxonomies | 2086S0127X Surgery, Trauma Surgery (Licence: MO 2004016404) |
| Enumeration Date | 2006-11-30 |
| Last Update Date | 2015-01-26 |