| NPI | 1841275575 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: VA 0101256590) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MN 509070) |
| Enumeration Date | 2005-12-15 |
| Last Update Date | 2022-09-20 |