| NPI | 1538123757 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WI 61778-21) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AR E-1046) |
| Enumeration Date | 2006-04-14 |
| Last Update Date | 2019-01-02 |