| NPI | 1437736592 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MA 1018105) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NH 34241) |
| Enumeration Date | 2021-03-25 |
| Last Update Date | 2025-07-25 |