| NPI | 1134330723 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NC 164120) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: VA 0101247695) |
| Enumeration Date | 2007-05-24 |
| Last Update Date | 2020-02-26 |