| NPI | 1679064513 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WA MD61340744) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AZ R76641) |
| 207P00000X Emergency Medicine (Licence: ID M-15349) | |
| Enumeration Date | 2018-05-26 |
| Last Update Date | 2023-02-14 |