| NPI | 1063089241 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: IA MD-53326) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IA R-12151) |
| 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: IA MD-53326) | |
| Enumeration Date | 2021-06-07 |
| Last Update Date | 2024-08-08 |