| NPI | 1629311485 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MD D97672) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NM MD2026-0112) |
| Enumeration Date | 2013-03-30 |
| Last Update Date | 2026-05-20 |