| NPI | 1548827447 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WA MD61414005) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 315781) |
| Enumeration Date | 2019-05-26 |
| Last Update Date | 2026-03-10 |