| NPI | 1992749071 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0127X Surgery Trauma Surgery (Licence: CA A042683) |
| Additional Taxonomies | 208600000X Surgery (Licence: CA A042683) |
| Enumeration Date | 2006-06-16 |
| Last Update Date | 2013-12-27 |