| NPI | 1831752062 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: GA 10815) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: GA 86762) |
| Enumeration Date | 2019-04-14 |
| Last Update Date | 2021-04-22 |