| NPI | 1285195966 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: VA 0102207309) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MO 2026015714) |
| Enumeration Date | 2019-03-26 |
| Last Update Date | 2026-08-07 |