| NPI | 1831485168 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OR MD184776) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AZ 50514) |
| 207P00000X Emergency Medicine (Licence: NV 16423) | |
| 207P00000X Emergency Medicine (Licence: ID M-14070) | |
| Enumeration Date | 2011-06-24 |
| Last Update Date | 2022-08-22 |