| NPI | 1306531819 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: IA DO-55540) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IA DO-55540) |
| Enumeration Date | 2023-04-10 |
| Last Update Date | 2026-08-06 |