| NPI | 1093102378 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WI 71253-20) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MD D0085181) |
| Enumeration Date | 2015-04-23 |
| Last Update Date | 2019-06-24 |