| NPI | 1215497987 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: ME MD27700) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MA 290959) |
| Enumeration Date | 2019-03-20 |
| Last Update Date | 2024-07-01 |