| NPI | 1609928779 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MD D0040089) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: DC MD18485) |
| Enumeration Date | 2007-01-17 |
| Last Update Date | 2026-07-21 |