| NPI | 1265925457 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TN 66694) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: SC LL52716) |
| 207P00000X Emergency Medicine (Licence: VA 0101272223) | |
| Enumeration Date | 2018-06-12 |
| Last Update Date | 2023-06-23 |