| NPI | 1700843190 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: VA 0101042188) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL ME106196) |
| Enumeration Date | 2006-04-28 |
| Last Update Date | 2021-06-21 |