| NPI | 1831539253 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: GA 74619) |
| Additional Taxonomies | 208600000X Surgery (Licence: MS T-2731) |
| Enumeration Date | 2013-06-29 |
| Last Update Date | 2022-07-21 |