| NPI | 1558001784 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OR DO224062) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: ID 2871348) |
| Enumeration Date | 2022-03-29 |
| Last Update Date | 2025-12-16 |