| NPI | 1023436656 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NH 18855) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: LA 306552) |
| Enumeration Date | 2014-04-01 |
| Last Update Date | 2018-05-03 |