| NPI | 1588922959 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: AL 33183) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL ME136837) |
| Enumeration Date | 2012-04-24 |
| Last Update Date | 2023-02-09 |