| NPI | 1972069276 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NE 2285) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OR DO224353) |
| Enumeration Date | 2019-02-12 |
| Last Update Date | 2026-03-16 |