| NPI | 1124656863 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NV 27167) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: ME MD23921) |
| 207P00000X Emergency Medicine (Licence: MD D97666) | |
| Enumeration Date | 2020-03-30 |
| Last Update Date | 2025-08-05 |