| NPI | 1457596645 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: TX K4784) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX K4784) |
| 208600000X Surgery (Licence: PA MD466253) | |
| Enumeration Date | 2008-12-03 |
| Last Update Date | 2023-09-12 |