| NPI | 1265019970 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: SC 95569) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NC 303135) |
| Enumeration Date | 2021-03-27 |
| Last Update Date | 2025-11-18 |