| NPI | 1780602474 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: LA 328481) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MO 2003026733) |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2024-12-12 |