| NPI | 1396034609 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: VA 0101289028) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MD D0090193) |
| Enumeration Date | 2011-04-07 |
| Last Update Date | 2026-06-23 |