| NPI | 1528062056 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OR MD22784) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: DC MD600005554) |
| Enumeration Date | 2005-06-13 |
| Last Update Date | 2026-04-23 |