| NPI | 1134328776 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TN 61269) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: VA 0101247213) |
| Enumeration Date | 2007-07-13 |
| Last Update Date | 2020-12-29 |