| NPI | 1063806040 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: GA 81386) |
| Additional Taxonomies | 208600000X Surgery (Licence: GA 81386) |
| Enumeration Date | 2015-03-27 |
| Last Update Date | 2023-03-07 |