| NPI | 1629506407 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: DC MD049047) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MA 272117) |
| Enumeration Date | 2017-05-24 |
| Last Update Date | 2021-04-13 |