| NPI | 1851345607 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WV 29626) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: VA 0101221494) |
| Enumeration Date | 2006-05-19 |
| Last Update Date | 2025-05-15 |