| NPI | 1114154051 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX P5578) |
| Additional Taxonomies | 208600000X Surgery (Licence: TX BP10034644) |
| Enumeration Date | 2009-06-18 |
| Last Update Date | 2013-06-24 |