| NPI | 1902368996 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OR MD209552) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: UT 11898964-1205) |
| Enumeration Date | 2019-04-01 |
| Last Update Date | 2022-10-28 |