| NPI | 1174143218 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NH 33126) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MA 1014885) |
| Enumeration Date | 2020-04-18 |
| Last Update Date | 2024-08-12 |