| NPI | 1265532717 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: UT 7935150-1205) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AZ 35336) |
| Enumeration Date | 2006-09-24 |
| Last Update Date | 2026-05-06 |