| NPI | 1831296615 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: VA 0101056648) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL ME71432) |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2023-06-22 |