| NPI | 1386024628 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: VA 0102206490) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL OS13511) |
| Enumeration Date | 2015-06-02 |
| Last Update Date | 2026-07-13 |