| NPI | 1588020911 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OR MD210073) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NE 30266) |
| Enumeration Date | 2016-01-14 |
| Last Update Date | 2022-08-29 |