| NPI | 1316267495 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NE 26658) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OR MD200368) |
| Enumeration Date | 2010-06-10 |
| Last Update Date | 2021-07-10 |