| NPI | 1952635575 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WI 57111-20) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AZ R71457) |
| Enumeration Date | 2009-09-29 |
| Last Update Date | 2022-07-22 |