| NPI | 1649857574 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: ME MD29172) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NH 34608) |
| Enumeration Date | 2021-03-26 |
| Last Update Date | 2025-04-22 |