| NPI | 1245764901 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: DC MD049293) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: VA 0101272337) |
| Enumeration Date | 2017-04-19 |
| Last Update Date | 2022-07-28 |