| NPI | 1811969033 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: VA 0101241849) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: DE C10002308) |
| Enumeration Date | 2006-02-02 |
| Last Update Date | 2019-06-10 |