| NPI | 1649701756 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: GA 101347) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA 142904) |
| Enumeration Date | 2017-03-21 |
| Last Update Date | 2025-01-03 |