| NPI | 1932698842 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: VA 0101276979) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MD483241) |
| Enumeration Date | 2018-05-07 |
| Last Update Date | 2024-02-09 |