| NPI | 1194283416 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WI 81740) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: SC 83612) |
| Enumeration Date | 2019-03-05 |
| Last Update Date | 2025-07-14 |