| NPI | 1740217264 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: AZ 22536) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: UT 9232865) |
| Enumeration Date | 2006-06-28 |
| Last Update Date | 2021-12-15 |