| NPI | 1154704500 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: GA 79263) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TN 57550) |
| Enumeration Date | 2015-07-02 |
| Last Update Date | 2022-12-29 |