| NPI | 1033188289 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: NV 11567) |
| Additional Taxonomies | 2086S0102X Surgery, Surgical Critical Care (Licence: WA MD61401956) |
| 208600000X Surgery (Licence: NV 11567) | |
| 208600000X Surgery (Licence: WA MD61401956) | |
| Enumeration Date | 2006-03-17 |
| Last Update Date | 2026-04-23 |