| NPI | 1073567319 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: ME MD20836) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NC 200001030) |
| Enumeration Date | 2006-05-20 |
| Last Update Date | 2024-07-03 |