| NPI | 1871750844 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: MI 4301092037) |
| Additional Taxonomies | 208600000X Surgery (Licence: WI 62529-20) |
| 2086S0127X Surgery, Trauma Surgery (Licence: MI 4301092037) | |
| Enumeration Date | 2008-05-19 |
| Last Update Date | 2016-05-03 |