| NPI | 1609914407 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: WA MD60013894) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WA MD 60013894) |
| Enumeration Date | 2007-02-02 |
| Last Update Date | 2023-08-24 |