| NPI | 1407203037 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: IA DO-05287) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IA R-10520) |
| Enumeration Date | 2016-05-24 |
| Last Update Date | 2023-05-26 |