| NPI | 1437654720 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 310257) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: GU MTL-2025-006) |
| Enumeration Date | 2018-03-28 |
| Last Update Date | 2025-06-12 |