| NPI | 1043877285 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MI 4301509456) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AZ 76462) |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: AZ 76462) | |
| Enumeration Date | 2019-05-23 |
| Last Update Date | 2025-05-02 |