| NPI | 1932289964 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: SC 27084) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MO 2015023836) |
| Enumeration Date | 2006-10-16 |
| Last Update Date | 2021-03-24 |