| NPI | 1710512371 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TN 71402) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WI 76472-20) |
| Enumeration Date | 2020-03-04 |
| Last Update Date | 2024-09-22 |