| NPI | 1982105292 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: ID O-1649) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OR DO209550) |
| Enumeration Date | 2018-02-22 |
| Last Update Date | 2023-08-10 |