| NPI | 1083290944 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: KY TP357) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AZ 010687) |
| Enumeration Date | 2021-03-22 |
| Last Update Date | 2024-12-09 |