| NPI | 1891747663 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0127X Surgery, Trauma Surgery (Licence: TX F9852) |
| Additional Taxonomies | 2086S0127X Surgery, Trauma Surgery (Licence: ID M-10061) |
| Enumeration Date | 2006-05-17 |
| Last Update Date | 2019-03-28 |