| NPI | 1821188293 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: TX M7750) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: LA 026288) |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2022-01-14 |