| NPI | 1013543248 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine Critical Care Medicine (Licence: FL ME165660) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL ME1656600) |
| 207P00000X Emergency Medicine (Licence: NV 27776) | |
| Enumeration Date | 2020-03-19 |
| Last Update Date | 2025-09-03 |