| NPI | 1215480181 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NC 2019-00520) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: GA 008575) |
| Enumeration Date | 2016-07-27 |
| Last Update Date | 2025-04-03 |