| NPI | 1881856144 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NC 2014-020703) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WV 2419) |
| Enumeration Date | 2008-06-27 |
| Last Update Date | 2021-11-22 |