| NPI | 1326054933 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: AZ 54608) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NM 77-261) |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2025-12-10 |