| NPI | 1447419668 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MN 56957) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WI 67003-21) |
| 207P00000X Emergency Medicine (Licence: NY 261731) | |
| 207P00000X Emergency Medicine (Licence: GA 70299) | |
| Enumeration Date | 2008-06-03 |
| Last Update Date | 2026-06-02 |