| NPI | 1538781315 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MI 4351046177) |
| Additional Taxonomies | 208600000X Surgery (Licence: MI 4351046177) |
| Enumeration Date | 2020-05-14 |
| Last Update Date | 2025-07-02 |