| NPI | 1265752331 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MO 2018001354) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IA 40282) |
| 207P00000X Emergency Medicine (Licence: IA R8957) | |
| Enumeration Date | 2010-06-10 |
| Last Update Date | 2022-09-12 |