| NPI | 1902547508 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: AZ 011625) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 5151015619APP22) |
| Enumeration Date | 2022-04-06 |
| Last Update Date | 2025-10-10 |