| NPI | 1396368882 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX U5908) | 
| Additional Taxonomies | 208600000X Surgery (Licence: TX BP10070467) | 
| Enumeration Date | 2020-05-19 | 
| Last Update Date | 2024-01-18 |