| NPI | 1942730247 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MO 2021027425) |
| Additional Taxonomies | 208600000X Surgery (Licence: MO 2021027425) |
| Enumeration Date | 2017-06-19 |
| Last Update Date | 2025-11-21 |