| NPI | 1710914213 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WI 34488-020) |
| Additional Taxonomies | 208600000X Surgery (Licence: WI 34488-020) |
| Enumeration Date | 2006-06-28 |
| Last Update Date | 2021-04-27 |