| NPI | 1326571258 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NC 2020-00927) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TN 57788) |
| Enumeration Date | 2017-04-07 |
| Last Update Date | 2024-02-09 |