| NPI | 1548606536 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: SC 93499) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NC 191583) |
| Enumeration Date | 2013-05-16 |
| Last Update Date | 2025-07-10 |