| NPI | 1508393497 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: GA 83044) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: GA 009074) |
| Enumeration Date | 2017-05-22 |
| Last Update Date | 2023-11-30 |