| NPI | 1003293739 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: VA 0102206150) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA OS020100) |
| Enumeration Date | 2015-05-01 |
| Last Update Date | 2022-04-25 |