| NPI | 1922386184 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MO 2013013922) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MO 2011017323) |
| Enumeration Date | 2011-07-21 |
| Last Update Date | 2021-04-23 |