| NPI | 1881157758 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: AZ 65975) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TN 0000062880) |
| Enumeration Date | 2019-04-09 |
| Last Update Date | 2022-06-14 |