| NPI | 1417488354 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: ID OC-0197) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NV DO2661) |
| Enumeration Date | 2017-03-22 |
| Last Update Date | 2022-08-23 |