| NPI | 1629561089 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: SC 52630) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: SC LL52630) |
| Enumeration Date | 2018-06-11 |
| Last Update Date | 2023-01-23 |