| NPI | 1154852432 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: VA 0101267433) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NC 2020-02936) |
| Enumeration Date | 2017-03-27 |
| Last Update Date | 2023-05-31 |