| NPI | 1922669167 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MO 2022044117) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MO 2019018220) |
| Enumeration Date | 2019-06-27 |
| Last Update Date | 2023-03-09 |