| NPI | 1588057038 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TN 65235) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: GA 95626) |
| Enumeration Date | 2015-03-09 |
| Last Update Date | 2025-04-04 |