| NPI | 1649226440 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NM md2013-0642) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: ID M-9682) |
| 207P00000X Emergency Medicine (Licence: MT 11099) | |
| 207P00000X Emergency Medicine (Licence: NV 10564) | |
| Enumeration Date | 2006-05-25 |
| Last Update Date | 2020-04-08 |