| NPI | 1528078060 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MT 10320) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IA 37638) |
| Enumeration Date | 2006-08-08 |
| Last Update Date | 2020-12-22 |