| NPI | 1588855803 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: AK 7612) |
| Additional Taxonomies | 204R00000X Electrodiagnostic Medicine (Licence: CA 20A11305) |
| 207P00000X Emergency Medicine (Licence: NV DO1534) | |
| Enumeration Date | 2007-08-05 |
| Last Update Date | 2020-10-07 |