| NPI | 1508122276 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA A141177) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: DE C1-0011345) |
| Enumeration Date | 2012-04-07 |
| Last Update Date | 2020-02-05 |