| NPI | 1235121526 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: VA 0101055783) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NC 9601373) |
| Enumeration Date | 2005-08-22 |
| Last Update Date | 2022-02-17 |