| NPI | 1922006980 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MD D0063688) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: DC 33616) |
| Enumeration Date | 2005-07-13 |
| Last Update Date | 2026-01-13 |