| NPI | 1497070486 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: OR MD184572) |
| Additional Taxonomies | 2086S0127X Surgery, Trauma Surgery (Licence: OR MD184572) |
| 208600000X Surgery (Licence: OR MD184572) | |
| 208600000X Surgery (Licence: WA 60642364) | |
| 2086S0127X Surgery, Trauma Surgery (Licence: WA 60642364) | |
| Enumeration Date | 2010-04-01 |
| Last Update Date | 2026-09-22 |