| NPI | 1295745073 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: AZ 32920) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: SC 85738) |
| Enumeration Date | 2006-08-08 |
| Last Update Date | 2025-09-19 |