| NPI | 1831399963 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: TX H8759) |
| Additional Taxonomies | 2086S0127X Surgery Trauma Surgery (Licence: TX H8759) |
| Enumeration Date | 2007-07-18 |
| Last Update Date | 2008-03-01 |