| NPI | 1730543067 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NV 24035) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AZ 55950) |
| 207P00000X Emergency Medicine (Licence: DC MD047322) | |
| Enumeration Date | 2016-04-12 |
| Last Update Date | 2023-09-08 |