| NPI | 1316568140 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: ND 17576) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: GU M-2482) |
| Enumeration Date | 2020-05-04 |
| Last Update Date | 2025-11-18 |