| NPI | 1174815955 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MO 2015014045) |
| Additional Taxonomies | 208600000X Surgery (Licence: OK 28647) |
| Enumeration Date | 2011-05-11 |
| Last Update Date | 2018-06-28 |