| NPI | 1235557638 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MO 2019010046) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NC 2016-02478) |
| Enumeration Date | 2014-04-02 |
| Last Update Date | 2022-09-02 |