| NPI | 1659322584 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: CA A90156) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA A90156) |
| 207P00000X Emergency Medicine (Licence: MD D66539) | |
| Enumeration Date | 2006-05-15 |
| Last Update Date | 2016-03-18 |