| NPI | 1689738072 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0127X Surgery, Trauma Surgery (Licence: FL ME108032) |
| Additional Taxonomies | 208600000X Surgery (Licence: CA A67135) |
| Enumeration Date | 2006-12-20 |
| Last Update Date | 2013-02-04 |