| NPI | 1366555708 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NV 11991) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AZ 32361) |
| Enumeration Date | 2006-08-17 |
| Last Update Date | 2019-12-09 |