| NPI | 1821066333 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: TN MD0000040296) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TN 40296) |
| 207P00000X Emergency Medicine (Licence: CA C146148) | |
| Enumeration Date | 2006-03-09 |
| Last Update Date | 2021-05-14 |