| NPI | 1790185486 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MD H0054848) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: DC DO31671) |
| Enumeration Date | 2014-08-29 |
| Last Update Date | 2025-04-24 |