| NPI | 1710248703 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: SC 36914) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: TX BP10044577) |
| Enumeration Date | 2012-06-06 |
| Last Update Date | 2023-07-18 |