| NPI | 1669553830 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: VA 0101232949) |
| Additional Taxonomies | 2086S0102X Surgery, Surgical Critical Care (Licence: VA 0101232949) |
| Enumeration Date | 2006-10-17 |
| Last Update Date | 2021-10-04 |