| NPI | 1518252998 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MA 257912) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MA 248526) |
| Enumeration Date | 2011-06-14 |
| Last Update Date | 2020-11-20 |