| NPI | 1215252135 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: SC 39668) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NC 2013-00627) |
| Enumeration Date | 2010-04-03 |
| Last Update Date | 2021-04-01 |