| NPI | 1114330370 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: CA A155210) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 35.129239) |
| Enumeration Date | 2014-06-05 |
| Last Update Date | 2023-11-27 |