| NPI | 1538374640 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MI 4301086023) |
| Additional Taxonomies | 208600000X Surgery (Licence: WA MD60714308) |
| 208600000X Surgery (Licence: OR MD28312) | |
| Enumeration Date | 2007-05-11 |
| Last Update Date | 2023-08-16 |