| NPI | 1023201829 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NV 22390) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL ME108215) |
| Enumeration Date | 2007-08-24 |
| Last Update Date | 2022-07-12 |