| NPI | 1073926531 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OR MD192751) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WI 65445-20) |
| Enumeration Date | 2014-06-03 |
| Last Update Date | 2019-09-24 |