| NPI | 1184991879 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: GA 72255) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL UO2554) |
| Enumeration Date | 2011-11-23 |
| Last Update Date | 2023-10-19 |