| NPI | 1891727798 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WA MD60636081) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 273206) |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2024-07-01 |