| NPI | 1427395326 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WA DO.OP.61664564) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: GU DO-0125) |
| 207P00000X Emergency Medicine (Licence: VA 0102203889) | |
| Enumeration Date | 2013-01-11 |
| Last Update Date | 2025-08-06 |