NPI | 1679070445 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA MD475372) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 35.137280) |
2086S0102X Surgery, Surgical Critical Care (Licence: PA MD475372) | |
Enumeration Date | 2018-04-09 |
Last Update Date | 2024-09-27 |