| NPI | 1336774447 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MI 288333) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MA 1019078) |
| Enumeration Date | 2020-03-09 |
| Last Update Date | 2025-10-14 |