| NPI | 1356070460 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: GA 98834) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CO DR.0076515) |
| Enumeration Date | 2022-06-06 |
| Last Update Date | 2026-06-02 |