| NPI | 1922414663 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0127X Surgery, Trauma Surgery (Licence: WA MD61264535) |
| Additional Taxonomies | 208600000X Surgery (Licence: NE 26768) |
| 208600000X Surgery (Licence: WA MD61264535) | |
| Enumeration Date | 2014-07-02 |
| Last Update Date | 2022-06-13 |