| NPI | 1659546273 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MO 2008013251) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: KS 04-34479) |
| Enumeration Date | 2008-04-24 |
| Last Update Date | 2020-03-04 |