| NPI | 1629273628 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NC 2014-00327) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NE 658) |
| Enumeration Date | 2007-06-19 |
| Last Update Date | 2025-03-20 |