| NPI | 1154673895 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: VA 0102204592) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL UO 2988) |
| Enumeration Date | 2012-10-04 |
| Last Update Date | 2020-07-28 |