| NPI | 1427168483 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine (Licence: WA 00028963) |
| Additional Taxonomies | 208D00000X General Practice (Licence: WA MD00028963) |
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: WA MD00028963) | |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2023-02-14 |