| NPI | 1649671926 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: VA 0101262575) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: VA 0116026941) |
| Enumeration Date | 2014-09-05 |
| Last Update Date | 2017-06-14 |