| NPI | 1205414315 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: LA 339404) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MS T-4470) |
| Enumeration Date | 2021-03-30 |
| Last Update Date | 2024-06-11 |