| NPI | 1730352642 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: VA 0101250480) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TN 46469) |
| Enumeration Date | 2008-04-11 |
| Last Update Date | 2022-01-12 |