NPI | 1902090061 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2086S0127X Surgery, Trauma Surgery (Licence: WA MD60365023) |
Additional Taxonomies | 2086S0102X Surgery, Surgical Critical Care (Licence: WA MD60365023) |
2086S0127X Surgery, Trauma Surgery (Licence: OR MD156740) | |
2086S0102X Surgery, Surgical Critical Care (Licence: OR MD156740) | |
Enumeration Date | 2007-08-31 |
Last Update Date | 2013-10-02 |