| NPI | 1982877478 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: WA MD60652293) |
| Additional Taxonomies | 208600000X Surgery (Licence: WA MD60652293) |
| Enumeration Date | 2008-04-07 |
| Last Update Date | 2016-09-02 |