| NPI | 1780027268 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: ID M-13292) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WI 63155-20) |
| 207P00000X Emergency Medicine (Licence: CA 143275) | |
| 207P00000X Emergency Medicine (Licence: AZ 51817) | |
| Enumeration Date | 2013-04-15 |
| Last Update Date | 2020-02-26 |