| NPI | 1962949842 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MO 2024009793) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NE 31208) |
| 207P00000X Emergency Medicine (Licence: WA MD61335948) | |
| Enumeration Date | 2017-01-30 |
| Last Update Date | 2024-09-19 |