| NPI | 1578024238 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MA 291584) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OR MD215105) |
| Enumeration Date | 2019-03-26 |
| Last Update Date | 2025-09-04 |