| NPI | 1295420610 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: GA 110742) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: GA 14806) |
| Enumeration Date | 2023-04-11 |
| Last Update Date | 2026-01-12 |