| NPI | 1174886824 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: ID OC-0411) |
| Additional Taxonomies | 208600000X Surgery (Licence: HI DOS-1605) |
| 2086S0102X Surgery, Surgical Critical Care (Licence: WA OP61134169) | |
| 208D00000X General Practice (Licence: HI DOS-1605) | |
| Enumeration Date | 2012-06-18 |
| Last Update Date | 2024-01-22 |