| NPI | 1073612065 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NV 8227) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL ME120450) |
| Enumeration Date | 2006-09-22 |
| Last Update Date | 2026-06-10 |