| NPI | 1679004097 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL 152679) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: GA 83864) |
| 207P00000X Emergency Medicine (Licence: KS 04-42862) | |
| 207P00000X Emergency Medicine (Licence: FL TRN24545) | |
| Enumeration Date | 2017-03-27 |
| Last Update Date | 2023-07-19 |