| NPI | 1114423233 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TN 66437) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WV 30461) |
| Enumeration Date | 2018-04-05 |
| Last Update Date | 2022-09-23 |