| NPI | 1962632125 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL OS12031) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 5101018186) |
| Enumeration Date | 2009-07-22 |
| Last Update Date | 2026-05-26 |