| NPI | 1851887624 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: SC 89262) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL ME150171) |
| Enumeration Date | 2018-07-05 |
| Last Update Date | 2023-03-02 |