| NPI | 1750653002 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: SC 82968) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: SC LL82968) |
| 207P00000X Emergency Medicine (Licence: WV 3304) | |
| Enumeration Date | 2012-02-02 |
| Last Update Date | 2022-01-11 |