| NPI | 1982929881 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OR DO214546) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NV DO1768) |
| 207P00000X Emergency Medicine (Licence: CA 20A12746) | |
| Enumeration Date | 2010-04-02 |
| Last Update Date | 2025-06-26 |