| NPI | 1336151034 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OR MD156637) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WA MD60440383) |
| 207P00000X Emergency Medicine (Licence: NY 223408) | |
| Enumeration Date | 2006-08-12 |
| Last Update Date | 2025-05-12 |