| NPI | 1124204151 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NC 2008-00794) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: GA 001331) |
| Enumeration Date | 2008-01-22 |
| Last Update Date | 2023-08-08 |