| NPI | 1376757732 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA A103662) |
| Additional Taxonomies | 208600000X Surgery (Licence: PA MT189281) |
| Enumeration Date | 2007-05-09 |
| Last Update Date | 2014-09-03 |