| NPI | 1871548073 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: GA 65968) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MN 48275) |
| 207P00000X Emergency Medicine (Licence: NC 0099-00501) | |
| Enumeration Date | 2006-05-24 |
| Last Update Date | 2024-07-24 |