| NPI | 1154432482 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: CA A113981) |
| Additional Taxonomies | 208600000X Surgery (Licence: WA ML20007938) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2011-06-29 |