| NPI | 1932588225 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: IA DO-04953) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IA R-10242) |
| Enumeration Date | 2015-05-20 |
| Last Update Date | 2018-06-22 |