| NPI | 1003300500 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MA 286158) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA mt215483) |
| Enumeration Date | 2018-06-18 |
| Last Update Date | 2022-04-20 |