| NPI | 1427021559 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MO 2019033217) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WA OP60128085) |
| 207P00000X Emergency Medicine (Licence: IA DO-03697) | |
| 207P00000X Emergency Medicine (Licence: IL 036100436) | |
| Enumeration Date | 2006-02-09 |
| Last Update Date | 2026-01-19 |