| NPI | 1952347296 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MD D0044394) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: LA 310143) |
| 207P00000X Emergency Medicine (Licence: NC 2017-02034) | |
| Enumeration Date | 2006-06-22 |
| Last Update Date | 2019-02-27 |