| NPI | 1669471454 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: TX J1828) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX J1828) |
| Enumeration Date | 2005-07-14 |
| Last Update Date | 2011-09-22 |