| NPI | 1710063573 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0127X Surgery Trauma Surgery (Licence: CA 141002) |
| Additional Taxonomies | 208600000X Surgery (Licence: WA MD00025766) |
| 2086S0127X Surgery Trauma Surgery (Licence: WA MD00025766) | |
| 2086S0102X Surgery Surgical Critical Care (Licence: WA MD00025766) | |
| 2086S0102X Surgery Surgical Critical Care (Licence: CA 141002) | |
| 208600000X Surgery (Licence: CA 141002) | |
| Enumeration Date | 2006-10-27 |
| Last Update Date | 2016-03-29 |