| NPI | 1710283460 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0127X Surgery, Trauma Surgery (Licence: GA 076559) |
| Additional Taxonomies | 2086S0127X Surgery, Trauma Surgery (Licence: NY 260095) |
| Enumeration Date | 2011-01-28 |
| Last Update Date | 2016-08-08 |