| NPI | 1093274839 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: DC CS210126228) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MD D0094938) |
| 207P00000X Emergency Medicine (Licence: VA 0101275209) | |
| Enumeration Date | 2019-03-19 |
| Last Update Date | 2022-08-12 |