| NPI | 1861690869 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0127X Surgery, Trauma Surgery (Licence: TX P6065) |
| Additional Taxonomies | 2086S0127X Surgery, Trauma Surgery (Licence: MO 2012034363) |
| Enumeration Date | 2007-07-11 |
| Last Update Date | 2013-10-09 |