| NPI | 1083175954 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: CT 076415) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CT 076415) |
| Enumeration Date | 2019-03-25 |
| Last Update Date | 2024-08-14 |