| NPI | 1467679464 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: ID O-0603) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OR DO184386) |
| 207P00000X Emergency Medicine (Licence: MO MEDICAL RESIDENT) | |
| Enumeration Date | 2007-04-19 |
| Last Update Date | 2024-03-01 |