| NPI | 1578882759 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: UT 4835882-1204) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AZ 005541) |
| 207P00000X Emergency Medicine (Licence: NV do1736) | |
| 207P00000X Emergency Medicine (Licence: CA 13545) | |
| Enumeration Date | 2010-05-26 |
| Last Update Date | 2023-10-25 |