| NPI | 1205861572 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: VA 0101102560) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: DC MD034914) |
| Enumeration Date | 2006-07-12 |
| Last Update Date | 2020-01-08 |