| NPI | 1366974776 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NE 32534) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WI 70441) |
| Enumeration Date | 2017-04-03 |
| Last Update Date | 2020-12-03 |