| NPI | 1265991491 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: VA 0101289195) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: DC MD210001906) |
| 207P00000X Emergency Medicine (Licence: NY 323553) | |
| Enumeration Date | 2019-03-18 |
| Last Update Date | 2026-07-28 |