| NPI | 1659718567 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: AZ 53916) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MA 255454) |
| Enumeration Date | 2013-05-31 |
| Last Update Date | 2022-07-21 |