| NPI | 1336644251 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: VA 0101274488) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: LA 323147) |
| Enumeration Date | 2018-03-25 |
| Last Update Date | 2023-10-10 |