| NPI | 1154732725 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX S2540) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MT206443) |
| 208600000X Surgery (Licence: PA MT206443) | |
| Enumeration Date | 2014-05-16 |
| Last Update Date | 2023-09-11 |