| NPI | 1043876626 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MI 5151015577) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AZ 011955) |
| Enumeration Date | 2019-05-19 |
| Last Update Date | 2025-09-17 |