| NPI | 1619467172 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: TX U2933) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OK 33971) |
| Enumeration Date | 2018-05-10 |
| Last Update Date | 2024-06-04 |