| NPI | 1952393274 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: SC 94816) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: GA 63266) |
| Enumeration Date | 2005-08-23 |
| Last Update Date | 2025-10-01 |