| NPI | 1225539182 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: ID 9171859) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: LA 335074) |
| 207R00000X Internal Medicine (Licence: ID 9171859) | |
| Enumeration Date | 2018-02-26 |
| Last Update Date | 2025-07-15 |