| NPI | 1598733560 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NC 2012-00243) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL ME0055435) |
| Enumeration Date | 2006-03-08 |
| Last Update Date | 2025-07-01 |