| NPI | 1134548290 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: WI 73740) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NE 30803) |
| 207P00000X Emergency Medicine (Licence: WI 73740) | |
| Enumeration Date | 2014-04-15 |
| Last Update Date | 2026-08-12 |