| NPI | 1851519078 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WI 51830) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NC 200601560) |
| Enumeration Date | 2007-04-23 |
| Last Update Date | 2026-04-28 |