| NPI | 1356978555 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME156656) |
| Additional Taxonomies | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: NH 34632) |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: KY TP281) | |
| Enumeration Date | 2020-03-26 |
| Last Update Date | 2025-07-23 |