| NPI | 1528298858 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: TX P7736) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX P7736) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2009-07-21 |
| Last Update Date | 2023-06-09 |