| NPI | 1134194772 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: GU M-2304) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CT 040218) |
| Enumeration Date | 2006-02-17 |
| Last Update Date | 2022-03-17 |