| NPI | 1740319870 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: OH 77159) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 77159) |
| Enumeration Date | 2007-03-05 |
| Last Update Date | 2025-11-25 |