| NPI | 1649808312 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NV DO3495) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AZ 010323) |
| Enumeration Date | 2020-03-30 |
| Last Update Date | 2024-04-24 |