| NPI | 1881031243 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: NC 2018-00158) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NC 2018-00158) |
| Enumeration Date | 2013-05-25 |
| Last Update Date | 2026-06-10 |