| NPI | 1508126418 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: SC 81975) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NC 2015-01219) |
| Enumeration Date | 2012-05-24 |
| Last Update Date | 2024-06-27 |