| NPI | 1376103283 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: PA OS025205) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA OS025205) |
| Enumeration Date | 2019-06-13 |
| Last Update Date | 2025-07-16 |