| NPI | 1821300013 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WY 9340A) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AZ R72188) |
| Enumeration Date | 2010-07-06 |
| Last Update Date | 2021-05-12 |