| NPI | 1992790273 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME145668) |
| Additional Taxonomies | 207PP0204X Emergency Medicine, Pediatric Emergency Medicine (Licence: IA MD-33521) |
| 207P00000X Emergency Medicine (Licence: IA MD-33521) | |
| Enumeration Date | 2005-09-13 |
| Last Update Date | 2025-03-24 |