| NPI | 1912341132 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: AL 49357) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WI 63458) |
| Enumeration Date | 2013-04-18 |
| Last Update Date | 2024-08-28 |