| NPI | 1912296989 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MT 33390) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: UT 39) |
| Enumeration Date | 2011-03-30 |
| Last Update Date | 2023-11-27 |