| NPI | 1083119929 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OR MD214950) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MD D90811) |
| Enumeration Date | 2018-03-23 |
| Last Update Date | 2023-08-16 |