| NPI | 1326252545 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: MO 102881) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MO 102881) |
| 2086S0102X Surgery, Surgical Critical Care (Licence: ID MC-0858) | |
| Enumeration Date | 2007-05-09 |
| Last Update Date | 2025-02-19 |