| NPI | 1528718947 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: UT 13509710-1205) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: ID 7371444) |
| Enumeration Date | 2022-03-28 |
| Last Update Date | 2025-06-05 |