| NPI | 1942662937 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: GA 103757) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: RI 0000) |
| Enumeration Date | 2016-03-28 |
| Last Update Date | 2026-04-23 |