| NPI | 1992265789 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0000X (Licence: FL OS18631) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL OS18631) |
| Enumeration Date | 2019-03-20 |
| Last Update Date | 2025-05-19 |