| NPI | 1073787867 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NM MD2011-0167) |
| Additional Taxonomies | 207PS0010X Emergency Medicine, Sports Medicine (Licence: NM MD2011-0167) |
| Enumeration Date | 2008-04-14 |
| Last Update Date | 2023-11-14 |