| NPI | 1548649627 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: SC LL37625) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NC 2018-00145) |
| Enumeration Date | 2015-05-22 |
| Last Update Date | 2018-05-30 |