| NPI | 1700922630 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MD T4326) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MA 1015218) |
| 207P00000X Emergency Medicine (Licence: CT 048159) | |
| 207LC0200X Anesthesiology, Critical Care Medicine (Licence: MA 1015218) | |
| Enumeration Date | 2007-01-29 |
| Last Update Date | 2025-04-14 |