| NPI | 1902224231 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TN 60882) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WI 64936-20) |
| Enumeration Date | 2014-04-03 |
| Last Update Date | 2021-06-17 |