| NPI | 1942273685 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: LA 022835) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NC 9700034) |
| Enumeration Date | 2006-02-13 |
| Last Update Date | 2021-05-27 |