| NPI | 1174705396 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 202K00000X (Licence: NC 200201009) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NC 200201009) |
| Enumeration Date | 2007-11-29 |
| Last Update Date | 2024-10-07 |