| NPI | 1699719864 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: GA 77610) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX N7417) |
| 207P00000X Emergency Medicine (Licence: IN 1057743A) | |
| Enumeration Date | 2006-06-16 |
| Last Update Date | 2025-10-10 |