| NPI | 1932163367 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: MN 32129) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MN 32129) |
| Enumeration Date | 2006-04-13 |
| Last Update Date | 2021-03-30 |