| NPI | 1700866126 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: AK 100432) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WI 46504-020) |
| 207P00000X Emergency Medicine (Licence: FL ME98908) | |
| Enumeration Date | 2006-01-20 |
| Last Update Date | 2020-10-07 |