| NPI | 1497076152 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NC 2018-02201) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WY 16295A) |
| 207P00000X Emergency Medicine (Licence: GA 70530) | |
| Enumeration Date | 2010-06-17 |
| Last Update Date | 2024-05-29 |