| NPI | 1396194726 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: DC MD600005225) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MA 277474) |
| Enumeration Date | 2016-06-07 |
| Last Update Date | 2026-04-07 |