| NPI | 1922097054 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0127X Surgery, Trauma Surgery (Licence: CA G88497) |
| Additional Taxonomies | 208600000X Surgery (Licence: CA G88497) |
| 2086S0127X Surgery, Trauma Surgery (Licence: NJ MA67676) | |
| 2086S0127X Surgery, Trauma Surgery (Licence: PA MD044438E) | |
| Enumeration Date | 2005-10-20 |
| Last Update Date | 2019-03-21 |