| NPI | 1821478322 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NC 2018-01477) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: SC LL38231) |
| Enumeration Date | 2015-06-01 |
| Last Update Date | 2021-11-23 |