| NPI | 1841305042 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: IA 37544) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WI 30778-020) |
| Enumeration Date | 2006-08-20 |
| Last Update Date | 2021-07-01 |