| NPI | 1457719023 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: VA 0102206441) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WI 81647-21) |
| Enumeration Date | 2016-02-10 |
| Last Update Date | 2024-09-17 |