| NPI | 1881914265 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: VA 0101251141) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: DE C1-0011121) |
| Enumeration Date | 2010-06-08 |
| Last Update Date | 2020-01-03 |