| NPI | 1003875303 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WI 46620) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: HI DOS-1523) |
| Enumeration Date | 2006-03-23 |
| Last Update Date | 2025-12-16 |