| NPI | 1669581427 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0127X Surgery, Trauma Surgery (Licence: WA MD00048682) |
| Additional Taxonomies | 208600000X Surgery (Licence: WA MD00048682) |
| 2086S0102X Surgery, Surgical Critical Care (Licence: WA MD00048682) | |
| Enumeration Date | 2006-08-29 |
| Last Update Date | 2015-05-19 |