| NPI | 1316409477 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MT MED-PHYS-LIC-112777) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: UT 7715884-1204) |
| Enumeration Date | 2019-04-05 |
| Last Update Date | 2023-01-04 |