| NPI | 1265727200 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: AR E-8183) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL ME125315) |
| Enumeration Date | 2011-06-17 |
| Last Update Date | 2023-01-31 |