| NPI | 1790278638 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: ND 19766) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NE 8323) |
| Enumeration Date | 2018-06-13 |
| Last Update Date | 2023-07-31 |