| NPI | 1750330353 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: VA 0101047692) |
| Additional Taxonomies | 208600000X Surgery (Licence: VA 0101047692) |
| Enumeration Date | 2006-05-09 |
| Last Update Date | 2009-12-23 |