| NPI | 1073776720 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NM MD2014-0527) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MO 2011014875) |
| Enumeration Date | 2008-07-02 |
| Last Update Date | 2023-07-10 |