| NPI | 1639442213 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: VA 0102205378) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TN 2609) |
| Enumeration Date | 2012-02-13 |
| Last Update Date | 2020-12-08 |