| NPI | 1134141500 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: AZ 2677) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MO 2019045526) |
| Enumeration Date | 2006-07-24 |
| Last Update Date | 2019-12-05 |