| NPI | 1033513858 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: OR DO225990) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: ID O-1600) |
| Enumeration Date | 2014-10-22 |
| Last Update Date | 2026-01-14 |