| NPI | 1063850006 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: GA 83338) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NC 2017-01385) |
| 207P00000X Emergency Medicine (Licence: CT 1.055474) | |
| Enumeration Date | 2013-06-12 |
| Last Update Date | 2022-07-21 |