| NPI | 1710327671 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NC 2016-01351) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: GA 006145) |
| Enumeration Date | 2013-06-25 |
| Last Update Date | 2022-11-30 |