| NPI | 1144977463 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: WA MD.MD.70098439) |
| Additional Taxonomies | 1744R1102X Specialist, Research Study |
| Enumeration Date | 2022-03-07 |
| Last Update Date | 2026-05-01 |