| NPI | 1164943213 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: SC 51190) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: SC LL51190) |
| Enumeration Date | 2017-06-29 |
| Last Update Date | 2020-11-11 |