| NPI | 1356862148 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NE 8111) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IA 47432) |
| Enumeration Date | 2017-06-30 |
| Last Update Date | 2022-07-21 |