| NPI | 1477178754 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: GA 99974) |
| Additional Taxonomies | 208600000X Surgery (Licence: SC LL83248) |
| Enumeration Date | 2020-06-11 |
| Last Update Date | 2024-09-14 |