| NPI | 1811239130 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: GA 85744) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MD D82284) |
| Enumeration Date | 2013-03-25 |
| Last Update Date | 2020-11-24 |