| NPI | 1245493766 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: AZ 43514) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AZ R70590) |
| Enumeration Date | 2008-07-03 |
| Last Update Date | 2020-09-15 |