| NPI | 1568969723 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: SC 94164) |
| Additional Taxonomies | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: FL 166038) |
| 207P00000X Emergency Medicine (Licence: FL 166038) | |
| Enumeration Date | 2018-04-12 |
| Last Update Date | 2025-07-14 |