| NPI | 1508285651 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MO 2015035393) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MD D83530) |
| Enumeration Date | 2014-04-15 |
| Last Update Date | 2020-07-24 |