| NPI | 1316042518 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WY 10737A) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: SC TL29317) |
| Enumeration Date | 2006-09-13 |
| Last Update Date | 2023-01-19 |