| NPI | 1306131883 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: VA 0101253042) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NC 2014-00376) |
| 207P00000X Emergency Medicine (Licence: TN 49410) | |
| Enumeration Date | 2011-06-13 |
| Last Update Date | 2021-12-02 |