| NPI | 1649837683 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: SC LL82550) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WV 32349) |
| Enumeration Date | 2019-05-24 |
| Last Update Date | 2024-08-14 |