| NPI | 1770679771 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: FL ME91240) |
| Additional Taxonomies | 174400000X Specialist (Licence: FL ME91240) |
| 2086S0127X Surgery, Trauma Surgery (Licence: FL M91240) | |
| Enumeration Date | 2006-10-05 |
| Last Update Date | 2022-07-22 |