| NPI | 1992357784 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: MO 2024033694) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MO 2024033694) |
| Enumeration Date | 2019-07-11 |
| Last Update Date | 2025-07-17 |