| NPI | 1134868334 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: SC 95859) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: GA 104389) |
| 207P00000X Emergency Medicine (Licence: GA 13771) | |
| Enumeration Date | 2022-06-03 |
| Last Update Date | 2025-12-05 |