| NPI | 1922628841 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TN 70700) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL ME160637) |
| Enumeration Date | 2020-04-21 |
| Last Update Date | 2024-11-21 |