| NPI | 1457790230 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MO 2017014183) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 5101020725) |
| Enumeration Date | 2013-06-14 |
| Last Update Date | 2018-12-27 |