| NPI | 1932150638 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0127X Surgery Trauma Surgery (Licence: MO 2014006605) |
| Additional Taxonomies | 208600000X Surgery (Licence: MO 2014006605) |
| 208600000X Surgery (Licence: SC 23291) | |
| Enumeration Date | 2006-05-15 |
| Last Update Date | 2020-10-26 |