| NPI | 1164742813 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NV DO1921) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MO 2012013458) |
| Enumeration Date | 2010-06-04 |
| Last Update Date | 2023-08-02 |