| NPI | 1619028610 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: VA 0101241879) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: GA 059508) |
| 207P00000X Emergency Medicine (Licence: FL TRN7802) | |
| Enumeration Date | 2007-01-16 |
| Last Update Date | 2021-07-21 |