| NPI | 1255727855 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NM MD2017-0835) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NM RS2015-0375) |
| Enumeration Date | 2015-04-09 |
| Last Update Date | 2023-07-21 |