| NPI | 1821297177 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: GA 63770) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: SC LL30041) |
| Enumeration Date | 2007-07-17 |
| Last Update Date | 2020-12-11 |