| NPI | 1740714757 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NV 26047) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NE 32401) |
| Enumeration Date | 2017-04-17 |
| Last Update Date | 2024-12-10 |