| NPI | 1508253709 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WA OP60925183) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 293460) |
| Enumeration Date | 2015-04-25 |
| Last Update Date | 2024-10-23 |