| NPI | 1053653394 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: TX S2774) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX S2774) |
| 207P00000X Emergency Medicine (Licence: NY 278356) | |
| Enumeration Date | 2013-03-25 |
| Last Update Date | 2023-11-28 |