| NPI | 1437679636 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WA MD61531935) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 314338) |
| Enumeration Date | 2017-06-20 |
| Last Update Date | 2024-09-18 |