| NPI | 1255332227 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0127X Surgery, Trauma Surgery (Licence: CA A55944) |
| Additional Taxonomies | 208600000X Surgery (Licence: CA A55944) |
| 2086S0102X Surgery, Surgical Critical Care (Licence: CA A55944) | |
| 2086S0127X Surgery, Trauma Surgery (Licence: WA 00049044) | |
| 208600000X Surgery (Licence: WA 00049044) | |
| 2086S0102X Surgery, Surgical Critical Care (Licence: WA 000449044) | |
| Enumeration Date | 2005-08-02 |
| Last Update Date | 2022-02-11 |