| NPI | 1356358311 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NM 2002-0149) |
| Additional Taxonomies | 208600000X Surgery (Licence: NM MD2002-0149) |
| Enumeration Date | 2006-08-02 |
| Last Update Date | 2023-11-29 |