| NPI | 1457872061 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: ID M-15000) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MO 2017023064) |
| Enumeration Date | 2017-07-05 |
| Last Update Date | 2022-06-01 |