| NPI | 1780663914 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: SC 18020) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: LA MD020881) |
| 207P00000X Emergency Medicine (Licence: NC 200200137) | |
| Enumeration Date | 2006-01-16 |
| Last Update Date | 2024-03-08 |