| NPI | 1487262028 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: UT 12952643-1205) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: KS 04-50072) |
| 207P00000X Emergency Medicine (Licence: MI 4301511326) | |
| 207P00000X Emergency Medicine (Licence: AZ 73231) | |
| Enumeration Date | 2020-07-20 |
| Last Update Date | 2024-09-30 |