| NPI | 1326492836 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: GA 82723) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL ME147535) |
| Enumeration Date | 2016-04-20 |
| Last Update Date | 2025-08-08 |