| NPI | 1538781869 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: KY 60559) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AL MD.47560) |
| Enumeration Date | 2020-05-08 |
| Last Update Date | 2025-07-03 |