| NPI | 1295146223 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WI 74348) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: VA 0101260237) |
| Enumeration Date | 2014-05-13 |
| Last Update Date | 2021-04-29 |