| NPI | 1689864456 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: GA 100519) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AZ 4707) |
| Enumeration Date | 2007-07-27 |
| Last Update Date | 2024-09-12 |