| NPI | 1811163199 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WI 2695) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: DE C7-0004008) |
| 207P00000X Emergency Medicine (Licence: CO 49891) | |
| 207P00000X Emergency Medicine (Licence: ME DO3369) | |
| Enumeration Date | 2008-05-06 |
| Last Update Date | 2023-05-10 |