| NPI | 1740336353 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0127X Surgery Trauma Surgery (Licence: CO DR.0049925) |
| Additional Taxonomies | 208600000X Surgery (Licence: CO 49925) |
| 208600000X Surgery (Licence: NC 2009-01098) | |
| Enumeration Date | 2007-01-26 |
| Last Update Date | 2018-11-30 |