| NPI | 1780787093 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: VA 0101237968) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: SC 21988) |
| Enumeration Date | 2006-09-06 |
| Last Update Date | 2018-07-10 |