| NPI | 1639675465 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OR DO213185) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AZ 009052) |
| Enumeration Date | 2018-04-02 |
| Last Update Date | 2023-07-10 |