| NPI | 1174745582 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: ID O0485) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IA IA-3634) |
| 208600000X Surgery (Licence: IA IA-3634) | |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2014-01-28 |