| NPI | 1902241144 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: SC 8991) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TN 54089) |
| Enumeration Date | 2013-05-01 |
| Last Update Date | 2020-10-26 |