| NPI | 1902062888 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: VA 0101246014) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: ID M-16582) |
| Enumeration Date | 2008-07-31 |
| Last Update Date | 2025-08-08 |