| NPI | 1528589827 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: SC 41060) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: SC LL41060) |
| Enumeration Date | 2017-06-28 |
| Last Update Date | 2020-11-10 |