| NPI | 1174507578 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: SC 12928) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MO 2021034317) |
| 207P00000X Emergency Medicine (Licence: KY 57335) | |
| Enumeration Date | 2005-11-30 |
| Last Update Date | 2022-12-16 |