| NPI | 1093153793 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NH 20104) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: UT 9873542-1205) |
| 207P00000X Emergency Medicine (Licence: MA 256057) | |
| Enumeration Date | 2013-06-05 |
| Last Update Date | 2020-03-21 |