| NPI | 1023247467 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA A124959) |
| Additional Taxonomies | 208600000X Surgery (Licence: RI LP01811) |
| Enumeration Date | 2009-07-07 |
| Last Update Date | 2018-02-07 |