| NPI | 1215355607 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WI 70854) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MA 273848) |
| Enumeration Date | 2014-04-02 |
| Last Update Date | 2024-04-11 |