| NPI | 1881701514 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: CA A123674) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: KY 44837) |
| Enumeration Date | 2006-08-25 |
| Last Update Date | 2025-07-09 |