| NPI | 1124448683 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: AZ 55805) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA 156182) |
| Enumeration Date | 2014-04-23 |
| Last Update Date | 2019-05-01 |