| NPI | 1811458649 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MD D94179) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WI 81282-20) |
| Enumeration Date | 2019-03-26 |
| Last Update Date | 2024-03-22 |