| NPI | 1609805431 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: TN MD38564) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TN 038564) |
| 207P00000X Emergency Medicine (Licence: VA 0101237006) | |
| Enumeration Date | 2006-07-02 |
| Last Update Date | 2019-07-10 |