| NPI | 1962580290 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0127X Surgery, Trauma Surgery (Licence: VT 042.0013187) |
| Additional Taxonomies | 2086S0127X Surgery, Trauma Surgery (Licence: VA 0101229859) |
| Enumeration Date | 2006-11-02 |
| Last Update Date | 2015-09-15 |