| NPI | 1770926149 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: GA 75420) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL 131593) |
| Enumeration Date | 2013-04-16 |
| Last Update Date | 2022-10-24 |