| NPI | 1376574863 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: GA 38564) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: GA 038564) |
| Enumeration Date | 2006-07-05 |
| Last Update Date | 2020-02-11 |