| NPI | 1245215037 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NC 2013-01711) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PR 15720) |
| Enumeration Date | 2005-12-14 |
| Last Update Date | 2024-02-28 |