| NPI | 1902211410 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NE 7281) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: ND 14545) |
| Enumeration Date | 2014-06-23 |
| Last Update Date | 2026-03-18 |