| NPI | 1689014920 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL OS13897) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA OT015487) |
| Enumeration Date | 2013-07-01 |
| Last Update Date | 2025-04-16 |