| NPI | 1417419771 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: AZ 65970) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MO 2022014288) |
| Enumeration Date | 2019-04-04 |
| Last Update Date | 2025-10-28 |