| NPI | 1225655657 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MO 2022042058) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MO 2020017365) |
| Enumeration Date | 2020-07-01 |
| Last Update Date | 2022-10-24 |