| NPI | 1457663213 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: KS 04-40034) |
| Additional Taxonomies | 208600000X Surgery (Licence: MO 2010018494) |
| Enumeration Date | 2010-07-09 |
| Last Update Date | 2023-11-02 |