| NPI | 1689615262 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: WA MD60484880) |
| Additional Taxonomies | 2086S0127X Surgery, Trauma Surgery (Licence: NV 12333) |
| 2086S0102X Surgery, Surgical Critical Care (Licence: NV 12333) | |
| 208600000X Surgery (Licence: NV 12333) | |
| Enumeration Date | 2006-06-08 |
| Last Update Date | 2023-03-07 |