| NPI | 1144513623 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: UT 9727531-1204) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NE 1046) |
| 207P00000X Emergency Medicine (Licence: ID O-0982) | |
| Enumeration Date | 2011-05-17 |
| Last Update Date | 2023-06-16 |