| NPI | 1730183435 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: AL 24104) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MS 24732) |
| 207P00000X Emergency Medicine (Licence: TN MD52119) | |
| Enumeration Date | 2005-06-09 |
| Last Update Date | 2025-11-05 |