| NPI | 1689294290 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TN 0000064938) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: GA 96310) |
| Enumeration Date | 2020-04-23 |
| Last Update Date | 2025-05-24 |