| NPI | 1578950994 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: AL MD.35693) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL ME136791) |
| Enumeration Date | 2015-04-23 |
| Last Update Date | 2019-01-17 |