| NPI | 1568998607 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: ND 15710) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: SC 95494) |
| Enumeration Date | 2017-05-11 |
| Last Update Date | 2026-02-11 |