| NPI | 1013612894 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MS 37049) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AL MD.50400) |
| Enumeration Date | 2023-04-03 |
| Last Update Date | 2026-06-11 |