| NPI | 1083279954 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CT 1.071122) |
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: CT 1.071122) |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: MA 295452) | |
| 207P00000X Emergency Medicine (Licence: MA 295452) | |
| Enumeration Date | 2019-05-07 |
| Last Update Date | 2026-10-04 |