| NPI | 1881657989 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: SC 26820) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NC 200301073) |
| Enumeration Date | 2006-04-10 |
| Last Update Date | 2022-10-11 |