| NPI | 1013169879 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME119973) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL TRN18079) |
| 208600000X Surgery (Licence: NE 24792) | |
| Enumeration Date | 2008-10-10 |
| Last Update Date | 2020-04-06 |