| NPI | 1700176690 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TN 8423165) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CO 363Amberge, Westin) |
| Enumeration Date | 2011-04-12 |
| Last Update Date | 2022-07-21 |