| NPI | 1720468101 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: ID O-1169) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IA R-10301) |
| Enumeration Date | 2015-06-01 |
| Last Update Date | 2018-07-03 |