| NPI | 1225001282 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: UT 9661223-1205) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: VA 0101054451) |
| Enumeration Date | 2006-02-09 |
| Last Update Date | 2021-09-15 |