| NPI | 1083698187 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: VA 0101252932) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: AR E-4191) |
| Enumeration Date | 2005-12-01 |
| Last Update Date | 2021-07-30 |