| NPI | 1659399293 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MA 1019653) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AZ 34553) |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2025-08-08 |