| NPI | 1558408765 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MD H66481) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MD T1875) |
| Enumeration Date | 2007-01-30 |
| Last Update Date | 2023-05-10 |