| NPI | 1962608067 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: OR MD164804) |
| Additional Taxonomies | 2086S0127X Surgery, Trauma Surgery (Licence: OR MD164804) |
| Enumeration Date | 2007-06-25 |
| Last Update Date | 2013-10-08 |