| NPI | 1356733182 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: SC 94405) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WI 75490) |
| Enumeration Date | 2015-03-03 |
| Last Update Date | 2025-06-21 |