| NPI | 1740238542 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: MO 2007008753) |
| Additional Taxonomies | 2086S0127X Surgery, Trauma Surgery (Licence: MO 2007008753) |
| 174400000X Specialist (Licence: TX L9894) | |
| Enumeration Date | 2006-05-04 |
| Last Update Date | 2009-04-30 |