| NPI | 1336844596 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: ME MD29662) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NH 40044) |
| Enumeration Date | 2023-04-04 |
| Last Update Date | 2026-08-04 |