| NPI | 1588814552 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0127X Surgery, Trauma Surgery (Licence: WA MD60292173) |
| Additional Taxonomies | 208600000X Surgery (Licence: TX M9878) |
| 208600000X Surgery (Licence: WA MD60292173) | |
| Enumeration Date | 2008-09-25 |
| Last Update Date | 2021-11-04 |