| NPI | 1538470810 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MO 2021005282) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL ME116565) |
| Enumeration Date | 2010-07-01 |
| Last Update Date | 2022-09-02 |