| NPI | 1043730690 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WI 72901) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NE 8089) |
| Enumeration Date | 2017-06-25 |
| Last Update Date | 2021-12-29 |