| NPI | 1568992220 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NM MD2020-0828) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NM 4301112793) |
| Enumeration Date | 2017-06-15 |
| Last Update Date | 2020-09-14 |