| NPI | 1548792153 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: AL MD.40930) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NC 2018-02101) |
| Enumeration Date | 2017-04-02 |
| Last Update Date | 2021-01-12 |