| NPI | 1235181892 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA OS0006812L) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WI 52173-21) |
| 207P00000X Emergency Medicine (Licence: MI 5101017118) | |
| Enumeration Date | 2006-05-16 |
| Last Update Date | 2023-03-07 |