| NPI | 1750722724 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: VA 0101262719) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MS T-2713) |
| Enumeration Date | 2013-07-08 |
| Last Update Date | 2020-04-09 |