| NPI | 1134298177 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: WA MD00037817) |
| Additional Taxonomies | 2086S0129X (Licence: CA A70974) |
| 208600000X Surgery (Licence: CA A70974) | |
| Enumeration Date | 2006-11-06 |
| Last Update Date | 2018-12-30 |