| NPI | 1588242671 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: ND 20980) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MN 71922) |
| 207P00000X Emergency Medicine (Licence: MN 31615) | |
| Enumeration Date | 2021-03-30 |
| Last Update Date | 2024-08-01 |