| NPI | 1669633137 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: SC 30717) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: SC TL30717) |
| Enumeration Date | 2008-06-18 |
| Last Update Date | 2022-11-01 |