| NPI | 1639174683 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MI 5101009198) |
| Additional Taxonomies | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: MI 5101009198) |
| 208600000X Surgery (Licence: MI 5101009198) | |
| Enumeration Date | 2005-06-16 |
| Last Update Date | 2019-12-13 |