| NPI | 1790725893 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TN MD034197) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: GA 39695) |
| 207P00000X Emergency Medicine (Licence: TN MD39695) | |
| Enumeration Date | 2006-06-07 |
| Last Update Date | 2025-10-30 |