| NPI | 1093194292 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX BP20065386) |
| Additional Taxonomies | 208600000X Surgery (Licence: TX 594023) |
| Enumeration Date | 2015-05-21 |
| Last Update Date | 2021-05-25 |