| NPI | 1295754075 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: AR e-2313) |
| Additional Taxonomies | 208600000X Surgery (Licence: MS 18052) |
| 208600000X Surgery (Licence: PA MD427685) | |
| 207P00000X Emergency Medicine (Licence: MS 18052) | |
| 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: OK 32355) | |
| Enumeration Date | 2006-07-19 |
| Last Update Date | 2024-11-18 |