| NPI | 1154850535 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PR 22600) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: GA 85633) |
| Enumeration Date | 2017-06-08 |
| Last Update Date | 2022-08-29 |