| NPI | 1902903784 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WI 30441) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL ME76912) |
| 207P00000X Emergency Medicine (Licence: HI 10435) | |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2017-04-07 |