| NPI | 1598450488 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: VA 0101288832) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: VA 0116037812) |
| Enumeration Date | 2023-04-07 |
| Last Update Date | 2026-06-30 |