| NPI | 1639733793 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NM MD2024-0664) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: SC 51275) |
| Enumeration Date | 2019-04-24 |
| Last Update Date | 2024-11-05 |