| NPI | 1619405917 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA OS025393) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: DE C2-0023891) |
| Enumeration Date | 2017-05-31 |
| Last Update Date | 2026-06-29 |