| NPI | 1134582596 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: GA 79012) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: GA 8547) |
| Enumeration Date | 2016-04-03 |
| Last Update Date | 2021-04-23 |