| NPI | 1700954088 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: AL DO.1159) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NC 2006-01308) |
| 207P00000X Emergency Medicine (Licence: AL 1159) | |
| Enumeration Date | 2006-12-02 |
| Last Update Date | 2023-06-29 |