| NPI | 1952385254 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: GA 049774) |
| Additional Taxonomies | 208600000X Surgery (Licence: GA 049774) |
| Enumeration Date | 2005-12-01 |
| Last Update Date | 2018-04-18 |