| NPI | 1265446892 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: VA 0101267584) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AZ 19308) |
| Enumeration Date | 2006-07-28 |
| Last Update Date | 2019-08-06 |