| NPI | 1851612246 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA A120024) |
| Additional Taxonomies | 208600000X Surgery (Licence: HI MDR-5916) |
| Enumeration Date | 2010-06-19 |
| Last Update Date | 2022-01-25 |