| NPI | 1063655769 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: GA 066442) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NC 2012-01106) |
| Enumeration Date | 2009-04-09 |
| Last Update Date | 2020-12-02 |