| NPI | 1720172828 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: KY 58525) |
| Additional Taxonomies | 208600000X Surgery (Licence: IL 036-092633) |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2023-11-16 |