| NPI | 1023647963 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: AL 47688) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL 160570) |
| Enumeration Date | 2020-04-03 |
| Last Update Date | 2026-03-30 |