| NPI | 1942721667 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: GA 009729) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NC 2020-03230) |
| Enumeration Date | 2017-07-03 |
| Last Update Date | 2025-03-25 |