| NPI | 1467915843 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OR MD229626) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL ME156667) |
| Enumeration Date | 2019-04-11 |
| Last Update Date | 2026-07-28 |