| NPI | 1821655234 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: VA 0101275504) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TN 65333) |
| Enumeration Date | 2019-05-21 |
| Last Update Date | 2022-08-16 |