| NPI | 1578898615 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: IA 4087) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AZ 005246) |
| Enumeration Date | 2009-10-07 |
| Last Update Date | 2022-04-21 |