| NPI | 1730337627 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: NY 262710) |
| Additional Taxonomies | 2086S0127X Surgery Trauma Surgery (Licence: NY 262710) |
| Enumeration Date | 2008-09-04 |
| Last Update Date | 2014-02-05 |