| NPI | 1215425145 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX U5186) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MO 2021021977) |
| 207P00000X Emergency Medicine (Licence: NJ 25MA10951600) | |
| Enumeration Date | 2018-04-26 |
| Last Update Date | 2025-11-24 |