| NPI | 1558892604 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NC 2020-02078) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NC 226892) |
| Enumeration Date | 2017-03-21 |
| Last Update Date | 2020-06-04 |