| NPI | 1407080450 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MA 274025) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A113658) |
| 207P00000X Emergency Medicine (Licence: CA A113658) | |
| Enumeration Date | 2009-05-05 |
| Last Update Date | 2025-09-11 |