| NPI | 1023697554 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: GA 99143) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AL 45238) |
| Enumeration Date | 2021-04-02 |
| Last Update Date | 2026-03-30 |