| NPI | 1861835845 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MO 2020039470) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NE 28442) |
| 207P00000X Emergency Medicine (Licence: KY 49549) | |
| Enumeration Date | 2013-04-09 |
| Last Update Date | 2021-07-20 |