| NPI | 1558777086 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MO 2018029412) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MO 2016020824) |
| Enumeration Date | 2014-07-03 |
| Last Update Date | 2019-08-16 |