| NPI | 1699139824 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NV 27765) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AK 144568) |
| Enumeration Date | 2016-04-13 |
| Last Update Date | 2025-07-31 |