| NPI | 1235543943 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: AZ 008799) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA 20A17388) |
| 207P00000X Emergency Medicine (Licence: UT 14236683-1234) | |
| Enumeration Date | 2014-06-20 |
| Last Update Date | 2025-08-25 |