| NPI | 1932586971 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MO 2023002880) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MO 2016039040) |
| 207P00000X Emergency Medicine (Licence: GU DO-0085) | |
| Enumeration Date | 2015-04-28 |
| Last Update Date | 2023-03-27 |