| NPI | 1982706156 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: ME 015349) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AZ 77916) |
| Enumeration Date | 2006-09-01 |
| Last Update Date | 2026-03-20 |