| NPI | 1073560876 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OR MD26812) |
| Additional Taxonomies | 174400000X Specialist (Licence: OR MD26812) |
| Enumeration Date | 2006-05-27 |
| Last Update Date | 2020-11-10 |