| NPI | 1033143409 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NC 9600633) |
| Additional Taxonomies | 207PS0010X Emergency Medicine, Sports Medicine (Licence: NC 9600633) |
| Enumeration Date | 2006-07-10 |
| Last Update Date | 2023-12-18 |