| NPI | 1669008710 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MT MED-PHYS-LIC-118840) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX T3385) |
| Enumeration Date | 2020-03-20 |
| Last Update Date | 2024-11-12 |