| NPI | 1568551521 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OR MD125955) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MO BB4745785-2005017258) |
| Enumeration Date | 2006-10-11 |
| Last Update Date | 2023-09-19 |