| NPI | 1972721850 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: AL MD.32359) |
| Additional Taxonomies | 208600000X Surgery (Licence: TN 46282) |
| Enumeration Date | 2007-04-23 |
| Last Update Date | 2019-12-09 |