| 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 |