| NPI | 1417344458 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OR MD197653) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: VA 0101263506) |
| Enumeration Date | 2015-04-16 |
| Last Update Date | 2020-06-19 |