| NPI | 1528003779 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA A97123) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: GA 055308) |
| 207P00000X Emergency Medicine (Licence: NM MD2026-0168) | |
| Enumeration Date | 2006-06-19 |
| Last Update Date | 2026-05-20 |