| NPI | 1659751295 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NV 21749) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: VA 0101261837) |
| Enumeration Date | 2015-06-08 |
| Last Update Date | 2023-08-16 |