| NPI | 1235163106 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: MS 21109) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: LA 200260) |
| 208600000X Surgery (Licence: LA 200260) | |
| Enumeration Date | 2006-07-10 |
| Last Update Date | 2020-08-03 |