| NPI | 1215382015 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0127X Surgery, Trauma Surgery (Licence: WA OP61548249) |
| Additional Taxonomies | 208600000X Surgery (Licence: MO 2023008400) |
| 208600000X Surgery (Licence: WA OP61548249) | |
| Enumeration Date | 2016-04-28 |
| Last Update Date | 2025-05-02 |