| NPI | 1942867767 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: SC 82540) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: SC LL82540) |
| Enumeration Date | 2019-05-28 |
| Last Update Date | 2022-06-23 |