| NPI | 1174044960 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WI 7520120) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MO 2017022159) |
| Enumeration Date | 2017-06-30 |
| Last Update Date | 2021-06-24 |