| NPI | 1144806670 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NV DO3639) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: KY 06280) |
| Enumeration Date | 2021-03-23 |
| Last Update Date | 2026-07-02 |