| NPI | 1659733491 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: GA 82539) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NC 217666) |
| Enumeration Date | 2016-03-22 |
| Last Update Date | 2019-08-19 |