| NPI | 1457476251 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: GA 69991) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: SC LL 29231) |
| 207P00000X Emergency Medicine (Licence: LA MD.202817) | |
| Enumeration Date | 2007-03-20 |
| Last Update Date | 2023-02-15 |