| NPI | 1154562304 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TN 52142) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: VA 0101282637) |
| Enumeration Date | 2009-03-18 |
| Last Update Date | 2025-04-29 |