| NPI | 1295485951 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WI 81879-21) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: LA 341228) |
| Enumeration Date | 2022-03-25 |
| Last Update Date | 2025-08-13 |