| NPI | 1922068154 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MD H0069397) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: VA 0102201169) |
| Enumeration Date | 2006-03-23 |
| Last Update Date | 2021-02-28 |