| NPI | 1881335644 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: HI 24829) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AL MD47360) |
| Enumeration Date | 2022-04-05 |
| Last Update Date | 2025-07-21 |