| NPI | 1760975965 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: SC 52713) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: SC LL52713) |
| Enumeration Date | 2018-06-12 |
| Last Update Date | 2021-03-15 |