| NPI | 1972162790 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MI 4301505674) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MI 4301505674) |
| Enumeration Date | 2019-06-06 |
| Last Update Date | 2025-09-11 |