| NPI | 1023423225 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MI 4301503901) |
| Additional Taxonomies | 208600000X Surgery (Licence: MA 260335) |
| Enumeration Date | 2014-06-25 |
| Last Update Date | 2022-11-04 |