| NPI | 1124256722 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: SC 1266) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: SC LL1266) |
| Enumeration Date | 2009-06-23 |
| Last Update Date | 2021-09-22 |