| NPI | 1699188524 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: AZ 65642) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MA 269672) |
| Enumeration Date | 2014-06-09 |
| Last Update Date | 2022-04-07 |