| NPI | 1356781215 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: SC 39979) | 
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: GA 006460) | 
| Enumeration Date | 2013-06-25 | 
| Last Update Date | 2020-10-27 |