| NPI | 1366766040 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: ME MD27637) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NH 23549) |
| 207P00000X Emergency Medicine (Licence: MD D76116) | |
| Enumeration Date | 2010-03-24 |
| Last Update Date | 2025-04-16 |