| NPI | 1932119088 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: SC 85495) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NC 011233708) |
| Enumeration Date | 2006-08-09 |
| Last Update Date | 2021-04-21 |