| NPI | 1326245903 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: VA 0101290105) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MD444131) |
| Enumeration Date | 2007-06-28 |
| Last Update Date | 2026-07-07 |