| NPI | 1013321769 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: ND 24057) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA OS025176C) |
| Enumeration Date | 2014-06-19 |
| Last Update Date | 2026-04-23 |