| NPI | 1093004772 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: MO 2018009676) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MO 2018009676) |
| 208D00000X General Practice (Licence: MO 2018009676) | |
| Enumeration Date | 2011-04-01 |
| Last Update Date | 2021-12-20 |