| NPI | 1538560206 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: PR 21288) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 292952) |
| 207P00000X Emergency Medicine (Licence: PR 21288) | |
| Enumeration Date | 2014-09-11 |
| Last Update Date | 2021-08-10 |