| NPI | 1245269711 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: LA 301145) |
| Additional Taxonomies | 208600000X Surgery (Licence: WA MD00042120) |
| 2086S0102X Surgery, Surgical Critical Care (Licence: MO 2009024741) | |
| 2086S0102X Surgery, Surgical Critical Care (Licence: HI 11327) | |
| 2086S0127X Surgery, Trauma Surgery (Licence: WA MD00042120) | |
| Enumeration Date | 2006-06-30 |
| Last Update Date | 2021-04-08 |