| NPI | 1033591961 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: ND PT15245) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NE 7530) |
| Enumeration Date | 2015-06-27 |
| Last Update Date | 2018-07-19 |