| NPI | 1740926633 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NH 39597) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CT 80682) |
| Enumeration Date | 2022-05-12 |
| Last Update Date | 2026-07-12 |