| NPI | 1194301549 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NV DO3634) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AZ 010980) |
| 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: AZ 010980) | |
| Enumeration Date | 2021-03-23 |
| Last Update Date | 2025-06-17 |