| NPI | 1548799455 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WI 81232-21) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WV 1374) |
| Enumeration Date | 2017-06-06 |
| Last Update Date | 2023-09-13 |