| NPI | 1780900100 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: SC 85737) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: GA 69422) |
| Enumeration Date | 2010-04-09 |
| Last Update Date | 2021-07-01 |