| NPI | 1841645595 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: AZ R75513) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: AZ R75513) |
| Enumeration Date | 2016-05-02 |
| Last Update Date | 2016-05-02 |