| NPI | 1619349024 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: AZ 62020) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PR 32053) |
| Enumeration Date | 2015-10-25 |
| Last Update Date | 2022-06-21 |