| NPI | 1720399975 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: UT 9055089-1205) |
| Additional Taxonomies | 208600000X Surgery (Licence: UT 9055089-1205) |
| Enumeration Date | 2010-06-23 |
| Last Update Date | 2021-12-20 |