| NPI | 1821352717 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: GA 073679) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: GA 005628) |
| Enumeration Date | 2012-06-26 |
| Last Update Date | 2025-05-06 |