| NPI | 1487002523 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: AZ 9314) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MO 2016016341) |
| Enumeration Date | 2016-05-31 |
| Last Update Date | 2021-11-04 |