| NPI | 1013658269 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: ID 3471857) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 5151015575) |
| Enumeration Date | 2022-04-03 |
| Last Update Date | 2025-06-05 |