| NPI | 1700107224 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0127X Surgery, Trauma Surgery (Licence: NC 2015-00377) |
| Additional Taxonomies | 208600000X Surgery (Licence: SC LL32849) |
| Enumeration Date | 2010-06-18 |
| Last Update Date | 2016-08-31 |