| NPI | 1710993324 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: GA 98263) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MA 160804) |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2024-01-16 |