| NPI | 1043446404 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: IA 39764) |
| Additional Taxonomies | 208600000X Surgery (Licence: IA R-8629) |
| Enumeration Date | 2009-05-29 |
| Last Update Date | 2011-10-31 |