| NPI | 1679797260 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MO 2014017392) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: LA DO.000244) |
| Enumeration Date | 2007-04-13 |
| Last Update Date | 2019-08-15 |