| NPI | 1790246320 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: ME MD24929) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NH 38904) |
| Enumeration Date | 2019-03-27 |
| Last Update Date | 2026-02-20 |