| NPI | 1295224723 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: LA 330577) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL ME149135) |
| Enumeration Date | 2018-05-10 |
| Last Update Date | 2022-07-04 |