| NPI | 1043664139 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WA MD61516763) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 297184) |
| Enumeration Date | 2016-04-15 |
| Last Update Date | 2025-02-17 |