| NPI | 1841360294 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WA MD60012956) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 232511) |
| Enumeration Date | 2006-11-09 |
| Last Update Date | 2025-03-19 |