| NPI | 1679573687 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: MD D0058088) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MD D0058088) |
| Enumeration Date | 2005-08-01 |
| Last Update Date | 2024-08-15 |