| NPI | 1942941562 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: ME DO4108) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MA 1025449) |
| Enumeration Date | 2022-04-06 |
| Last Update Date | 2025-12-10 |