| NPI | 1801979711 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: VA 0101248048) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: SC Q19646) |
| Enumeration Date | 2006-10-23 |
| Last Update Date | 2019-08-30 |