| NPI | 1023329976 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: IA DO-05225) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MT 19065) |
| 207P00000X Emergency Medicine (Licence: GA 074216) | |
| Enumeration Date | 2010-06-25 |
| Last Update Date | 2023-05-01 |