| NPI | 1063909513 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NV 22250) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL ME149706) |
| Enumeration Date | 2018-04-20 |
| Last Update Date | 2022-08-01 |