| NPI | 1265881569 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: IA MD-44687) |
| Additional Taxonomies | 207PS0010X Emergency Medicine, Sports Medicine (Licence: IA 44687) |
| Enumeration Date | 2016-06-07 |
| Last Update Date | 2025-03-21 |