| NPI | 1306873716 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: SC MD94699) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MA 220753) |
| Enumeration Date | 2006-06-28 |
| Last Update Date | 2025-08-19 |