| NPI | 1831176981 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: IA MD-25600) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: GA 044066) |
| Enumeration Date | 2005-12-29 |
| Last Update Date | 2025-04-04 |