| NPI | 1417489659 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MT MED-PHYS-LIC-116650) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MT 74240) |
| Enumeration Date | 2017-03-28 |
| Last Update Date | 2025-08-14 |