| NPI | 1922395367 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: VA 0102204099) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA OS016601) |
| 207P00000X Emergency Medicine (Licence: PA OT013900) | |
| Enumeration Date | 2011-07-06 |
| Last Update Date | 2020-09-04 |