| NPI | 1396107827 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: AZ 58628) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MT MED-PHYS-LIC-13550) |
| Enumeration Date | 2016-03-23 |
| Last Update Date | 2026-01-21 |