| NPI | 1649561671 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: LA 323523) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL ME119472) |
| Enumeration Date | 2011-04-25 |
| Last Update Date | 2021-09-28 |