| NPI | 1982609244 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0127X Surgery, Trauma Surgery (Licence: AZ 21323) |
| Additional Taxonomies | 174400000X Specialist (Licence: AZ 21323) |
| Enumeration Date | 2005-06-14 |
| Last Update Date | 2012-05-15 |