| NPI | 1942383690 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MI 4301061773) |
| Additional Taxonomies | 208600000X Surgery (Licence: MI 4301061773) |
| Enumeration Date | 2006-10-23 |
| Last Update Date | 2019-05-21 |