| NPI | 1629425079 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MI 5101022248) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: HI DOS-2059) |
| Enumeration Date | 2016-05-16 |
| Last Update Date | 2025-06-02 |