| NPI | 1619141793 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: SC 40551) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MA 229547) |
| Enumeration Date | 2008-04-18 |
| Last Update Date | 2018-07-19 |