| NPI | 1952591745 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: TX P3942) |
| Additional Taxonomies | 208600000X Surgery (Licence: IL 125-053525) |
| 207P00000X Emergency Medicine (Licence: TX P3942) | |
| Enumeration Date | 2007-07-27 |
| Last Update Date | 2023-04-21 |