| NPI | 1841559820 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: ID MC-2774) |
| Additional Taxonomies | 208600000X Surgery (Licence: WA MD60875669) |
| Enumeration Date | 2012-05-10 |
| Last Update Date | 2024-04-18 |