| NPI | 1568656213 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NV 13789) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AZ 43398) |
| Enumeration Date | 2007-09-05 |
| Last Update Date | 2020-09-15 |