| NPI | 1184203895 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: WI 88672) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MD483281) |
| Enumeration Date | 2021-04-08 |
| Last Update Date | 2026-08-26 |