| NPI | 1316148836 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OR MD27693) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: VA 0101240270) |
| Enumeration Date | 2007-05-31 |
| Last Update Date | 2025-08-04 |