| NPI | 1811952971 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME153423) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA A87616) |
| 207P00000X Emergency Medicine (Licence: HI MD - 13711) | |
| Enumeration Date | 2006-04-19 |
| Last Update Date | 2025-03-12 |