| NPI | 1396763009 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: VA 0101237797) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WV 18600) |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2024-11-25 |