| NPI | 1346604766 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0127X Surgery, Trauma Surgery (Licence: WA MD61280566) |
| Additional Taxonomies | 2086S0102X Surgery, Surgical Critical Care (Licence: WA MD61280566) |
| 208600000X Surgery (Licence: WA MD61280566) | |
| Enumeration Date | 2016-04-12 |
| Last Update Date | 2024-02-27 |