| NPI | 1740809763 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: SC 95595) |
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: NC 2022-02218) |
| 207R00000X Internal Medicine (Licence: NC 2022-02218) | |
| 207P00000X Emergency Medicine (Licence: NC 2022-02218) | |
| Enumeration Date | 2020-04-09 |
| Last Update Date | 2026-08-26 |