| NPI | 1952506669 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: SC 32960) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: VA 0101243) |
| Enumeration Date | 2007-06-21 |
| Last Update Date | 2021-05-20 |