| NPI | 1255350328 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OR MD23640) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AZ 71262) |
| Enumeration Date | 2006-07-19 |
| Last Update Date | 2024-08-01 |