| NPI | 1205889193 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WV 3123) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: VA 0102201209) |
| Enumeration Date | 2006-05-19 |
| Last Update Date | 2022-04-20 |