| NPI | 1285074526 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MT 42235) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AZ R73931) |
| Enumeration Date | 2013-07-01 |
| Last Update Date | 2022-05-12 |