| NPI | 1477634335 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: ME EC-05-081) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: KY 59926) |
| Enumeration Date | 2006-10-18 |
| Last Update Date | 2026-03-09 |