| NPI | 1477901247 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: ID M-14616) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WI 6514-851) |
| Enumeration Date | 2016-06-02 |
| Last Update Date | 2019-09-19 |