| NPI | 1215990817 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: GA 079352) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NC 200000983) |
| Enumeration Date | 2006-04-07 |
| Last Update Date | 2020-03-30 |