| NPI | 1760979074 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: VA 0101282275) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: LA 330275) |
| Enumeration Date | 2018-04-23 |
| Last Update Date | 2024-08-16 |