| NPI | 1881657088 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NC 200500310) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OR MD229791) |
| Enumeration Date | 2006-04-10 |
| Last Update Date | 2026-06-17 |