| NPI | 1124412382 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MA 278140) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: ME MD21681) |
| Enumeration Date | 2015-03-26 |
| Last Update Date | 2020-11-19 |