| NPI | 1942650031 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL OS18445) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WV 3589) |
| Enumeration Date | 2016-06-20 |
| Last Update Date | 2022-02-07 |