| NPI | 1780203620 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TN 68531) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL ME157213) |
| Enumeration Date | 2020-04-10 |
| Last Update Date | 2025-01-11 |