| NPI | 1083110514 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: AL 44444) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TN 63891) |
| Enumeration Date | 2018-04-03 |
| Last Update Date | 2025-08-29 |