| NPI | 1710366869 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NE 30563) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NE 7396) |
| Enumeration Date | 2015-05-22 |
| Last Update Date | 2021-08-12 |