| NPI | 1851853477 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: UT 12659892-1205) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AZ 64749) |
| Enumeration Date | 2019-04-02 |
| Last Update Date | 2023-06-01 |