| NPI | 1588059190 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MO 2018000530) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MO 2016018015) |
| Enumeration Date | 2015-03-31 |
| Last Update Date | 2018-01-16 |