| NPI | 1457330037 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MO 112400) |
| Additional Taxonomies | 208600000X Surgery (Licence: MO 112400) |
| Enumeration Date | 2006-01-12 |
| Last Update Date | 2023-03-07 |