| NPI | 1811557028 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MO 2021016748) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MO 2019018213) |
| Enumeration Date | 2019-06-19 |
| Last Update Date | 2021-06-08 |