| NPI | 1164009320 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: ME MD29224) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MA 288718) |
| Enumeration Date | 2021-03-25 |
| Last Update Date | 2025-07-29 |