| NPI | 1164600961 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: VA 0101243589) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: VA 0116017555) |
| Enumeration Date | 2008-02-04 |
| Last Update Date | 2023-02-21 |