| NPI | 1821105628 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: CA A74578) |
| Additional Taxonomies | 2086S0127X Surgery Trauma Surgery (Licence: MO 2018027900) |
| 2086S0127X Surgery Trauma Surgery (Licence: CA A74578) | |
| Enumeration Date | 2006-08-25 |
| Last Update Date | 2021-02-25 |