| NPI | 1962065466 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NV 26883) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OR MD230543) |
| Enumeration Date | 2019-04-19 |
| Last Update Date | 2026-06-04 |