| NPI | 1689611840 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: MO R8A85) |
| Additional Taxonomies | 2086S0127X Surgery Trauma Surgery (Licence: MO R8A85) |
| Enumeration Date | 2006-05-31 |
| Last Update Date | 2021-02-05 |