| NPI | 1811942444 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WI 30013-020) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WI 30013-20) |
| Enumeration Date | 2006-05-23 |
| Last Update Date | 2021-12-17 |