| NPI | 1689202434 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: AR E-19571) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NV 23820) |
| Enumeration Date | 2020-03-28 |
| Last Update Date | 2025-07-28 |