| NPI | 1720441504 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: AL MD.41359) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MS T-3124) |
| 207PS0010X Emergency Medicine, Sports Medicine (Licence: TN 59053) | |
| 207PS0010X Emergency Medicine, Sports Medicine (Licence: AL 41359) | |
| Enumeration Date | 2016-03-30 |
| Last Update Date | 2023-05-09 |