| NPI | 1174681639 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TN 41757) |
| Additional Taxonomies | 208600000X Surgery (Licence: TN 41757) |
| Enumeration Date | 2006-12-05 |
| Last Update Date | 2007-07-16 |