| NPI | 1184851701 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TN 54947) |
| Additional Taxonomies | 208600000X Surgery (Licence: GA 074155) |
| Enumeration Date | 2009-06-22 |
| Last Update Date | 2019-03-01 |