| NPI | 1285131391 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NM DO2023-1101) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NV DO3277) |
| 207P00000X Emergency Medicine (Licence: NV SL1381) | |
| 207P00000X Emergency Medicine (Licence: AZ 011818) | |
| Enumeration Date | 2018-04-06 |
| Last Update Date | 2026-02-04 |