| NPI | 1821354457 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: SC 37620) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY AS 7163304-824) |
| 207P00000X Emergency Medicine (Licence: GA RTP 005566) | |
| Enumeration Date | 2012-04-09 |
| Last Update Date | 2020-11-11 |