| NPI | 1902168735 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NC 2013-02154) |
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: NC 2013-02154) |
| Enumeration Date | 2012-06-07 |
| Last Update Date | 2017-01-25 |