| NPI | 1922368976 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: VA 0101260017) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MA 288007) |
| Enumeration Date | 2012-05-24 |
| Last Update Date | 2022-12-08 |