| NPI | 1386204816 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: SC 82758) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: SC LL82758) |
| Enumeration Date | 2019-06-17 |
| Last Update Date | 2022-01-10 |