| NPI | 1083078398 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NH 34570) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: ID M-14684) |
| 207P00000X Emergency Medicine (Licence: CT 69535) | |
| 207P00000X Emergency Medicine (Licence: DE C1-0027244) | |
| Enumeration Date | 2016-04-12 |
| Last Update Date | 2025-03-31 |