| NPI | 1861531865 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NM MD2006-0789) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NM MD2006-0789) |
| Enumeration Date | 2007-02-06 |
| Last Update Date | 2025-06-13 |