| NPI | 1376832709 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NC 2014-00605) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MD D0084169) |
| Enumeration Date | 2011-04-06 |
| Last Update Date | 2021-11-15 |