| NPI | 1508002833 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: VA 0101257372) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: VA 0116025086) |
| Enumeration Date | 2008-12-16 |
| Last Update Date | 2022-08-15 |