| NPI | 1558866228 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: OR MD219512) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NM MD2024-0745) |
| 207P00000X Emergency Medicine (Licence: UT 11405430-1205) | |
| Enumeration Date | 2018-03-26 |
| Last Update Date | 2024-10-17 |