| NPI | 1932737293 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WI 81067) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: VA 0116033953) |
| Enumeration Date | 2020-03-31 |
| Last Update Date | 2023-07-10 |