| NPI | 1164956116 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: AL 40640) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TN 59272) |
| Enumeration Date | 2017-04-17 |
| Last Update Date | 2020-06-25 |