| NPI | 1821017492 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: DC MD039259) |
| Additional Taxonomies | 208600000X Surgery (Licence: MD D71965) |
| 2086S0127X Surgery, Trauma Surgery (Licence: DE C1-0008069) | |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2013-05-28 |