| NPI | 1740458173 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0127X Surgery, Trauma Surgery (Licence: NY 9441191) |
| Additional Taxonomies | 2086S0127X Surgery, Trauma Surgery (Licence: CA A102760) |
| 2086S0127X Surgery, Trauma Surgery (Licence: FL ME115740) | |
| Enumeration Date | 2008-02-19 |
| Last Update Date | 2017-04-06 |