| NPI | 1396486155 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MS 34007) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL OS22348) |
| Enumeration Date | 2022-04-05 |
| Last Update Date | 2025-05-23 |