| NPI | 1831167204 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NM A-1827-14) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX G1961) |
| 208600000X Surgery (Licence: NM A-1827-14) | |
| 208600000X Surgery (Licence: TX G1961) | |
| Enumeration Date | 2006-03-10 |
| Last Update Date | 2022-11-11 |