| NPI | 1578004891 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TN 70341) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MD D0093059) |
| 2086S0102X Surgery, Surgical Critical Care (Licence: MD D0093059) | |
| Enumeration Date | 2017-03-20 |
| Last Update Date | 2024-04-22 |