NPI | 1366738312 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208600000X Surgery (Licence: WA MD60848138) |
Additional Taxonomies | 208600000X Surgery (Licence: NC 2017-00874) |
2086S0102X Surgery, Surgical Critical Care (Licence: WA MD60848138) | |
Enumeration Date | 2011-06-28 |
Last Update Date | 2018-09-20 |