| NPI | 1790739928 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: GA 58755) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NV 7672) |
| Enumeration Date | 2006-05-20 |
| Last Update Date | 2024-04-24 |