NPI | 1700179660 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: OH 35139875) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 35139875) |
207P00000X Emergency Medicine (Licence: PA MD450447) | |
Enumeration Date | 2011-05-25 |
Last Update Date | 2022-08-08 |