| NPI | 1053842666 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: AL 48332) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MA 287656) |
| Enumeration Date | 2017-03-24 |
| Last Update Date | 2024-08-28 |