| NPI | 1134574544 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL 140654) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NC 217986) |
| Enumeration Date | 2016-05-04 |
| Last Update Date | 2022-07-11 |