| NPI | 1336636042 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: GA 88722) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MS 27943) |
| Enumeration Date | 2018-04-18 |
| Last Update Date | 2021-06-09 |