| NPI | 1508209313 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: MO 2017024760) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MO 2017024760) |
| 208D00000X General Practice (Licence: MO 2017024760) | |
| Enumeration Date | 2013-04-10 |
| Last Update Date | 2024-04-25 |