| NPI | 1225086762 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MA 286873) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NC 200000267) |
| 207P00000X Emergency Medicine (Licence: MN 64659) | |
| Enumeration Date | 2006-05-05 |
| Last Update Date | 2022-05-25 |