| NPI | 1740863794 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: DE C1-0029486) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: DE C1-0029486) |
| 207P00000X Emergency Medicine (Licence: MD D0106800) | |
| 207R00000X Internal Medicine (Licence: MD D0106800) | |
| Enumeration Date | 2021-04-28 |
| Last Update Date | 2026-07-20 |