| NPI | 1396039350 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MD D86544) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA 199733) |
| 207PP0204X Emergency Medicine, Pediatric Emergency Medicine (Licence: MD D86544) | |
| Enumeration Date | 2011-06-07 |
| Last Update Date | 2025-01-16 |