| NPI | 1366821696 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: VA 0101274588) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NE 29818) |
| Enumeration Date | 2015-05-19 |
| Last Update Date | 2022-04-18 |