| NPI | 1578024386 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: GA 103107) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: GA 103107) |
| 207P00000X Emergency Medicine (Licence: MD D93614) | |
| Enumeration Date | 2019-03-26 |
| Last Update Date | 2025-08-08 |