| NPI | 1093399115 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: SC 92122) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NC 2025-02424) |
| Enumeration Date | 2021-05-06 |
| Last Update Date | 2026-05-19 |