| NPI | 1518404565 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: GA 92773) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AL MD.41153) |
| Enumeration Date | 2017-01-30 |
| Last Update Date | 2022-08-08 |